AF - 465486ERALD T. CAYNE
30t1 B&UNSWICK AVE S. LOT SURVEYS C01111PAN
601QEM VALLEY, MINN.
'MINN. REG, NO. 4741 LA�1D :i�VEYOR.S
eEC�r�n uxa� Usare oF srs� oF a��ars
78D1 - 73rd Ave. No. 66Q-3083
INDUSTRIAI — JUDICt/►L Minnee�lis, Minnesota 56428
COMMERCIAL — TOPOC-�RAPHIC/1L
c�rr �ors — PUTiING �D�1p1JD1`B I�p�tCF��p
S�J. CONSTRUCTION
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RAYMOND A. PRASCH
64I7 IDAHO ^VE N.
@ROOKLYN PARK, MINN.
MINN. REG. NO. 6743
INYOICB NO. 6�,73�
F. & NO. �,?%�L:�
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Q — DEN07E5 IRON
Denotes Wood Hub
Set For Excavation
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Lots 1, 2, 3, and 4, Block A� Hiverview
Heights, except the East 30 feet thereof.
I�evi�ed 9-19-7g Ta show Buildir�� Foundat,ion
Ws 6a�eby uMi�y thet 4hb ic e t�ue eed corteN repre�nta wn � ��' i �
of e survay of �Yrs boundori�s of th� e�va dascr+bed lend and � �J' >° , �
ths locatian of ell buildiags end visibta encroechmeets, if eny, �,r: ��. .__ �,�a �.�,� '',, �'�''� `° `
from or on taid lend. $jgg�j ° '"• `' - — .
$ J LUT SURVEYS'' COMP�II�TY �
Syeveyed l�qr m this t��ilay of A.U�iIS� 19�_
sue�ecr PERMIT NO.
City of Fridley 485'7
AT THE TOP OF THE TWINS g U I L D I N G P E R M i T
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� � ECEIPT NO.
� ; L ____ COMMUNITY DEVELOPMENT DIV. �
r � � PROTECTIVE INSPECTION SEC. � S
1 ; �
i_-_' � �"'1,� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE � OF APPROVED BV
� � � � , 812-580-3450
910-F15 8/17/78 � �
JOB ADDRESS 450 Iiugo Street N. E.
1 LEGAI LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ].-4, ex. 30' A R1VG'iVl@W HEl JPI't.S SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
S. J. Construction Tnc. 6305 East River R�ad N.E. Fridley, RIl�i 560-2970
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS � ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP pHONE LICENSENO.
SEPlR� •
B USE OF BUILDING HE,��� � En Ft�R tNFRf�V
�tesiaentia� �' PLU1�B}NG
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
_�,
8 DESCRIBE WORK
Construct a 40` x 24' D�rrelling and a 2Q' x 24' Garage
9 CHANOEOFUSEFROM TO •
STIPULATIONS provide a hard surface driveway. Provide a verifying survey and �
�by Sept. 15, 1978. Provide sod in the ficont and side yarc7s. If fuel fixed
furnace used, provide combustion air. Record 1ot split with Anoka Co�ty office
vaithin 3 da.ys from issuance of permit. Mainta.in minimum 10 foot setback from
nea.rest dripli.ne of power line.
SEWER LOCATION: C�PProx. 22' Deep In Stxeet) Wye Only with 6 foot.riser 125 feet
east of manhole C�• =nv. 838.351 WYE ELEV: 838.69 + 6 foot riser.
WATER LOCATION: Service i.s eactended. Contact City Water Depart�nent for e�ca,ct
location.
DRIVEWAY DEPRESSION COST: N/A Existing 30 foot depression (too wide�)
� � . o� � � �� a�A� C�` WARNq��
��� ap vrnmr toGt+� ic�a - t�v�ra�s. Beiare ��in� e�t lecat utifill�s
�� �� � �R ��� Pu��S ��`Y � 1'ELEPi1011E - fLECTRiC • GA-5 Etc.
►�sa�a w�wc rt a�ovw v��c n� r,�o�aw►
SEPARATE PERMITS ARE REQUIRED POR ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. O w,t • CjUP 1� D
VENTILATING OR AIR CONDITIONING. , Wood Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R—�. 9GO �" 4BO Z���OO TO�lI.
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFPSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE ORANTING OF A PERMIT $32iS�O S�-G.�i4
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHAHGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMA OF CONSTRUCTION. SS9G.00 $400.00
PLAN CHECKFEE TOTALFEE
�'� � °" �� .00 536.44
SIGNATUREOFCONTRA TORORAUT EDAGENT (DATEI HEN PROPERLY VALIDATED THIS IS YOUR PERMIT
°�� ' � C�°-�-f-T�r�
SIGNATUREOFOWNEHIIFOWNERBUILDERI � IDATEI BLDG.INSP DATE
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CITY or- FfZIU�EY
' /1PPLTC�'fl0f�d FOfZ RESII)f=NTI/OL BUII_DIP�G PERMITS
' �I1�CI�f, IILTLR/1TIONS, �DDITIOtd�, GR REPAIRS)
owr��R: S�'� �o.�csr�i c�� �.✓�.�vzLDLr�: � � � `� :. .
Address : S� Nrl � � nddress :
Tel. tvo. �� � � q°�� ��
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No. treet: � � Q �, �� 4
� Z1 3��- �X��� ?f+�� �R���O ' T�f�a�o�
LOT: / BTACY.: �_ ADDITION: �/ ��/� �/j�� f�E/ � ��'
i /
CORIQER LOT: INSIDE LOT: SLTBACY.: _� STDLYAItDS: I�
Applic�'r,t attach 'to this form �1ao Certiiicates of Survey of Lot and proposed
bui.ldinq location drawn on these Certificates. .
DESCRI PTTOPd OF BUI LDT NG
To Be Used As:
�� � Front: � Depth: �� Height: % _�`
Square Feet: 9�[� Cubic Fe�t: �
�A-���"�' Fx'ont: `� � Depth: � �' � Height: + ��
� Square Feet: � Cubic Feet: ����
Type oi Construction: �� F} h/1 � Estimated Cost: $� �
7.b Te Campleted: �� � � �2f ��� �
II�O� /a9 �t.
Proposed Drive�aay Width If New Opening Is besired $ $ �
(SE� REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specifi�d� agreeiiig to do all t.�ork in strict accordance �viti� the Cit}� of
� Fridley Ordinances and rulings of the Department oi' BL111.C�1I]�S i ancl hereby
� eclares L-hat all thc facts a��d representations stat "n this ap�lication
re trueiand correct. See xeverse side for addi 'oial i format'on.
D71Ti: �� I - 1 � % � SIGNATUP.E:
Sti ulations: � � �'�' ��' �r , p/
p �iy.y1 i i� /�L /.t, � i� '/ �O s �`l1
� �� / oF �� a�[ �2 i�, �
��y:. — �.� � //L�L
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BUILDI(JG PER��IIT FEt SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection
of any building or structure, or for any addition to any existing building or structure,
or for any alteration or repairs to any er.isting building or structure, upon application
therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet..
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSZON: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 fe€t�x $14.50
Alternate B: Removal and replacement of concrete curb and
qutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$7-7•20
�� 11 � : 1 �' : �
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the grour.d area covered from a
point six (6) inches below the floor line of the basement or th� cellar to the
average heights of the upper surface or to the average height of the roof surface
of the main gable of a pitched roof .
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 �ier each five hundred d611ars ($500.00) or fraction thereof in the cost
of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge. -
VERIFICATIOiV OF FOUNDATION �
NOTE: Permits for construction will be issued a minimum of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
_CE�TIFICATE OF OCr�PANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
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l. Addre ss �� „L��'� ��, �� � ,
2. Lega l. i� Sl h� c.P�,� �� ' r_.�
3 . Zoning ;� ° / � ,
� � 4. Lot Width �/��� • , .
5.• Building Width �p
. 6.. Front Setback ,3�� �
• 7. Total Use ��' .
. 8. Lot �Coverage �t� •
� . . Ease�tents � P�ti . � � . .
. � 0. Variance . �/ �. ,� � ���
11.� Soil ��-�. �' '�
. 12. Contractor' � Q���
. 13. Phone -- . c
. • 14. Architect -- -
15. Drainage. �t�, � , � '
16. Energy Aslirae �B� ' .
17. Utility Locations ✓' •
18. Specials � , v
19. Driveway opening �► .
• 2';uss Design � �
1 Combustion Air . • .
. • �"•. . . • . - s -
.
. 23. ' . � ' . . ' � -
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L��9D S1�1�8b��O�i
4002 JEFFERSON ST. N.E.
COLUlNBIA HEIGHTS 55421
788-9769
��Y C�RT17V TF1AT TF119 BURVUL7/. @'LAP1. OR RCPAR7 1NA9 PRSiPAtRL�D BY ME OR UNDER Ml/ DtRLCT SUPLRF/:afON
ANO TMAT 1 AM � DULY Rl�OIOTeR�D LANG OURV6�70ii UNDER TNB LAdV� O� TN� BiAT6 OR pIINNESOTA.
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MIMNE54'91A REGISTRATION NO. 5332
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"DISlON SAFE7y �OyTROI ZOW��d
�H N��H PLANT OR PLAC� ANY•
F'ROVq! OFHIS AREq WITMpUT qP
TNE CIiY OF FRtOk�;Y�
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�►.��YB�dkG1f OP WFORMATION PUCtPOSfS ON4Y AN�
'��k� @�l�.�A► ES FOR {t�,A�ION
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SE�EPN R�� �� <A� ��o�k � .
���V, Description- "A"- The east 30 feet of Lots 1,2,3,and 4 ARi�ervietv
Heights, and all o�' lots 5 and 6, Riverview Neights.
"B"- Lots 1,2,3, and 4,URivervie�r Heights, excep� the
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- >�November 30, 1978
�ni,. �-.�.k .,°.
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8431 UNIVERSITY AVENUE N.E.� FRIDLEY, MINNESOTA 6b432
TELEPHONE ( 812)571-3450
Mr. John R. Doyle
S. J. Construction, Inc.
63Q5 East River Road N.E.
_ Fridley, 1�V 55432
Re: Final Inspection at 450 Hugo Street N.E.
Dear Mr. Doyle:
A final inspection was made on November 29, 1978 of the ataove address and
the follawing items were noted which must be corrected before the structure
can be finaled out;
1. Provide sod in the front and side yards by June 1, 1979.
2. Render patio door inoperative until deck is pmvided on or before
Deceiaber 15, 1978.
3. Install joist hangers on cut floor joist under bathrocan by
Deceznber 15, 1978.
We will expect the above items to be campleted by the scheduled dates ivhen
reinspections will be made to determine compliance. If you have any
questions on�these items, please contact me at 571-3450.
� Sincerely,
DARREL G. Q,ARK
Coamnunity Develo,pment Adm.
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CITY OF FRI�LEY
8431 UNIVERSITIf AVENUE N.E., FRIDLEII. MINNESOTA 55432
TELEPHONE ( 812)571-3450
Mr. Frank J. Hegner
450 Hugo Street N.E.
Fridley, MA1 55b32
Re: Displaying a Sign on the East River Road Right of Way
Dear Mr. Hegner:
It was confirmed by an on-site inspection on April 19, 1983 that you
were displaying a sign advertising "Hegner Trophies" on a utility
pole located at the intersection of Hugo and East River Road.
Section 21u.031 of the Fridley City Sign Code does not permit any
permanent signs other than governmental signs to be erected Within
any street right of �ay or upon any public easement.
Therefore, the City must require that the sign be removed from this
location. In addition� the City Zoning Code does not permit the
displaying of any signs advertising a home oceupation on the
premises. It Would be expected that after the sign is removed from
the easement, it would not be erected at your residence.
The City is confident in your cooperation on this matter and if any
questions arise from this letter, please feel free to call on me at
571-3u50.
To determine compliance with this letter, a reinspection will be
conducted on or about May 2, 1g83.
Sineerely�
�
STEVEN J. OLSON, R.S.
Environmental Officer
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DATEs
TOt
FROM:
3IIHJECT:
Community Development Department
PLANNING DTVISION
City of Fridley
July 10, 1992
Jim xill, Acting City Manager
Barbara Dacy, Community Development Director
Steven Barg, Planning Assistant
Home Occupation/450 Hugo Street N.E.
Recently you referred a letter from an anonymous resident along
with a flyer indicating that trophies and sports cards are being
sold at a business conducted at the above referenced address.
Staff contacted the owner of this business and advised him that
such activity constitutes an unlawful home occupation. Staff
infornaed him that he would have seven days to cease this business
activity, and• °a --followup letter was sent to him confirming this
information (copies of this letter along with the original
complaint information are attached).
Please be advised that this individual will be permitted to operate
this business today through Sunday as indicated on the attached
flyer. However, please be advised that this activity could create
some minor parking and traffic problems in the area. As indicated
in the attached letter, any activity on or after July 17, 1992,
will be prohibited and enforcement action wil�. be taken.
Please let us know if you have questions or wish to discuss this
further..
SB:ls
CEM-92-53
�,k��, :;'.' ..�`'u
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C � _
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-t287
July 10, 1992
Frank Hegner
450 Hugo Street N.E.
Fridley, MN 55432
RE: Home Occupations
Dear Mr. Hegner:
In the zoning district where you live, home occupations are
permitted as an accessory use, provided that certain criteria are
met. Two of these requirements (City Code copy enclosed) are as
follows:
1. No over-the-counter retail sales are involved.
2. Any home occupation shall be clearly incidental and
secondary to the principal use of the premises and shall
not change the residential character.
Recently we were informed that you are operating a sports card and
trophy business out of your residence which is not in conformance
with the restrictions. Our conversation of July 9, 1992, confirmed
this to be correct.
Any violations of this ordinance occurring on or after July 17,
1992, will be subject to criminal prosecution. Please comply with
the City Code by discontinuing this activity immediately.
Feel free to call me at 572-3595 if you have questions or wish to
discuss this further. Thanks for your cooperation!
Sincerely,
Steven Barg
Planning Assistant
SB:ls
C-90-334
s�e�EC� PERMIT NO.
City of Fridley 2 8 9� 9
AT THE TOP OF THE TWINS g U I L D I N G P E R M i T
r
� � RECEIPT NO.
' ' COMMUNITY DEVELOPMENT OIV.
f � v � � PROTEC7IVE INSPECTION SEC. /��m�, �,
� -� �
� _ .
� �"'1 � CITY NALL FRIDLEr SS�32 NUMBEN N8v OATE vAGE Oi APVRpVEO 8�
ti..__1l: '., 612-571-3450 910-F15 2/19/99
/ /
lOB ADDRESS 450 Hugo Street NE
1 LEGAI �OT NO. BLOCK TRACT Ofi ADDITION SEE ATTACHED
DESCR. 1—L} A Riverview Heights Addition SNEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Frank Aegner 450 Hugo Street NE
3 CONTRACTOR MAIL ADDRESS ZIP PNONE LICENSE NO
Jayson Lindsay Roofing 2638 Clearview Ave, Mounds View, MN 55112 792-1857
4 ARCNITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO.
20098263
5 ENGINEER MAIL ADORESS ZIP PMONE LICENSE NO
8 USE OF BUILOING
Residential
7 CLASS Of WOqK
O NEW O ADDITION � ALTERATION �7 REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (22 Sq) Tear-off
9 CHAN(3E OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REGUIRED FOFi EIECTRICAL. PLUMBING. HEATING, TVPE OF CONST. OCCUPANCY GROUP OCCUPANCV �OAD
VENTILATING OR AIF CONDITIONING.
TMIS PERMIT 9ECOMES NULL AND VOIO IF WORK Oii CONSTRUCTION 20NING SO. fT CU fT
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOEO OR ABANDONEO FOFi A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWIG. UNITS OFFSTREET PAqKING
I MEREBY CERTIFY TMAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORREC7. ALL PROVISIONS OF �AW$ VA�UATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITM WME7HER SPECIFIED MEREIN OR NOT. TME GRAN?ING OF A PERMIT �1 fHHS �.94
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE Op CANCEL TMF pEqMIT FEE SAC CMARGE
PROVISIONS OF ANY OTHER STA OR LOCAI LAW REGUTATING coN- �59. SO Fire SC �1 . SS
STqUCT ON OR THE PERFORMA OF CONSTRUCTION
PLAN CMECK fEE TOTAL FEE
License SC $5.00 $67.32
Si NATU O�CON'AACTQAOAAUTflO EO GENT �D�TEi WMEN PROPEA VALIOATED TMIS IS V ii PEf:M�T
- � - �'i� ��
S�GN4fUqEO�OWNEAi��OWNEpBU4DE�ii iD�tE� � BL G�NS� r��rE
T1EW
ADDN
ALTER
[l
[l
[l
CITY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: -7 � I~l � � � �J�
Effective 1 / 1 /99
. j � �������
� ,�
4�` '�
Legal Description:
Owner Name & Address: �--(CA=J'I� �� i9til �. r2 Tel. #
Contractor: eJ � �i� MN LICEN5E #� d��i a6 �
Address• �� � a �l �V[�� � . Tel. � 7 % � -/ 8 �'_' 7
' Attach to this application, a Certificate of 5urvey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IlIZPROVEMENT
Length Width Height Sq. Ft.
Length Width Height 5q. Ft.
Length
��:a.�.
Sq. Ft.
� �����
Construction Type: %�,� ��t- 7�►+Z � Estimated Cost: $,��T�
. (Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = _ FtJr�$ _$
DATE: - R�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Fscrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ ,So
$ .
$ �
$
$ ��d
$
$
$
$
$ � .��
Tel. # `�6� - 7�0� � _
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 per 5AC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A° or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
BUII.DING PERNIIT FEE SCHEDULE
The Cluef Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure; upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit� �
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,OQ0,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,OQ0 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50, 000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100, 000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1, 000 or fraction thereof, to and including $1, 000, 000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1, 000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Slreets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site. .
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required Uefore praceeding with the framing.
SuB�ECi
City of Fridley
AT THE TOP OF TME TWINS g U I L D I N G P E R M I T
i �
� �
� `y __��� COMMUNITY DEVELOPMENT DIV.
r � � PAOTEC7IVE INSPECTION SEC.
� _ �
� �"'1 � CITY HALL FRIOLE� SS132 NUMBER
�'""�� ,�� 612-571-34b0 910-Ft 5
lOB AOORESS 450 Hugo Street NE
1 LEGAL �OT NO.1 _ 4. BLOCK TRACT OF AODITION
oescR. Exc. E. 30' A Ri vervi ew He�
2 PROPERTY OWNER MAII AODRES$
Frank Hegner
3 CONTRACTOR MAIL ADDRESS
Owner
4 ARCHITECT OR OESIGNER MAIL AODRESS
5 ENGINEER MAIL AODRESS
8 USE Of BUILDING
Residentia1
7 CLASS OF WOFiK
8 DESCRIBE WORK
Reside house
9 CHAN(3E OF USE FROM
STIPULATIONS
NEV DATE
5/25/99
ZIP
ZIP
� �
�..-�v
PNONE
PMONE
PMONE
29542
RECEIPT O
3/l�
APVROVED B�
SEE ATTACFIED
SNEET
LICENSE NO
IICENSE NO.
LICENSE NO
O NEW �] ADDITION ❑ ALTERATION �X REPAIR O MOVE O REMOVE
. no „ Q�
TO
Call for building wrap inspection before covering.
See stipulations on plan.
SEPARATE PEIiMITS ARE REOUIRED FOR EIECTFICAL. PLUMBING, MEATING, TYPE OF CONST
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING
AUTMOR12E0 IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONEO FOR A PERIOD OF 120 pqYS AT
ANY TIME AFTEq WORK IS COMMENCED. NO. DWLG. UN
I MEIiE9Y CERTIFY THAT I MAVE REAO ANO EXAMINEO THIS APP�ICATION
ANO KNOW THE SAME TO BE TRUE AND CORRECT. A�L PqOVISIONS OF LAWS ypLUATION
AND ORDINANCES GOVERNING THIS TYPE Of WORK WILL BE COMPLIED �3000
WITM WME7MER SPECIf1ED HEREIN OR NOT. TNE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOIATE OR CANCEL THE pEpMITfEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON• $83. Z5
STqUCTION Oii THE PERFORMANCE OF CONSTRUCTION
S�GN4T F CO 1� 4CT0 O•UTMOA�ZED AGENT IOATE�
� N4TUaE � NE �� OWN wlOEa� �DAfE� �
• �
F _�
E' �������
' $efore digging c.a�� for
all util+ty loca`•::o1�
454•0�3�t
REQUiR�D t�Y �1�t
OCCUPANCVGROUP OCCUPANCVLOAD
SQ.FT CU FT.
OfFSTf1EET PARKING
STA�LS GAiiAGES
SUR7Ax
$1.50
SAC CMAiiGE
Fire SC $3.00
TOTA EE
$ .75
VALIDA D NIS IS VOUFI PERM17
� � � ��
�
p6tE
rrEw�
ADDN �
�,�R L l
Construction Address:
Legal Description:
Effective 5/10/99
CITY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R 1 AND R 2
BUII..DING PERMIT APPLICATION
� 5���
/��
�,"J �
1 ��
o�
Owner Name & Address: ���l,�c ���-��� �-- ���l�� Tel. #�/,� — % ' � ?�-
Contractor: MN LICENSE #
Address:
Attach to this applica.tion, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
Tel. �
LNING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height 5q. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
�
oTI�R: ��s��� � �� � �;��I�� � � �X � ���.� �e��i`�`cc�
,
Construction Type: Estimated Cost: $� �Q��
Driveway Curb Cut Width Needed:
DATE: �=�..5 =� APPLICANT:
.S
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� �� ��
� �, �.�
� �, �
$
$
$
$
$
$
$ ��
Tel. # ��,� - �G� v �=��
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%) �
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. °B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
BUII..DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addition to any existing building or structure, or for any alteration or repair to any existing building or structure,
upon application therefore, require the payment by the applicant for such permit of fees to the amount herein
below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,0(?0
$2,001 to $25,000
$25,001 to $50,0�
$50,001 to $100,000
$1(?�,001 to $500,000
$SOO,OUl to $1,(�0,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,Ot� plus $14.OU for each additional $1,000
or fraction thereof, to and including $25,OOU
$391.25 for first $25,�0 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1, 000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,Ot10 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,0(}0 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,0(}0 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSIOI�1 ESCROW
(Concrete Ci�rb Streets Only)
Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been coaistr�ucted �vill
be required before proceeding with the framing.
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Building
Inspections
763-572-3604
DATE�SITE ADDRESS
THIS APPLICAM' I3:
PROPERTY
OWNER/
TENANT
�C�I�,� PermitNo.� (��i�'�I�
RESIDENTIAL APPLICATIOl�T Re�ei�ed By: t�
CI'TY o� ���� D��� 0 U 2 0 20
YOUR E-MAIL ADDRES'S •
� .i n
❑ OWNER
CONTRACTOR co�r�Na�: Sharp Heating & A. C.
SUBMIT A COPY OF CONTACT PERSON: FlOyd J03W�Ck
YOUR STATE STATE LICENSE f{ E3�' DATE
LICENSE WITH ,�D�S: 722� pnivers�ve. N. E. � Fridiey sTA� MN�, 55432
APPLICATION pHONE 763-572-04�9 FAX •
PER10'IIT TYPE
TYPE OF WORK: I � �
FAMILY O TWO FAIvBLY
�REPLACE1t2ENT
DETAILED DESCRIP'FION OF WORK
O TO�NfiOUSE
❑ ALTER�TION/REMODBI.
PER MS 16B.665 the permit fee is a minimnm of 515.00 or S% of t6e total�cost np to $50�:�0; whichaver is .greater, for the
improvement, installation or replacement of a residential fixture, excluding the fpctwes. (This should reflect only the cost of lahor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x,OS =
FOR PROJECTS Wi�RE LABQR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, E7{CEPT WH�RE.NOTED F�C!'�J�: (�ICAT$ TOTAL
NUMBER OF EACH BELOV� �, /► ��A J
Equipmentinstalled ° MFG: «"001'NtN MpDEI,; 3 � SIZFIB•1°U�
MFG: MODEL: ' �
SIZEJBTU
MFG: MODEL: SIZFJBTU
_A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGFlOVEN $10.00
_AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW QAS GRII,L $10.00
_BOIL.ER $35.00 LFURNACE $35.00 _GAS UNI1' HTit$10.00
_CHIMNEY LINER $I0.00 _GAS DRYER $10.00 POOL HEATER $35.00
_DUCT WORK �10.Q0 GAS PIPINQ $10.00 • VEIVTII,pTOR $15.00
Permit Fee $
Surcharge $ ,50
TOTAL DUE $
i�wuvcr vi nxnffe3 (� �I0.00 X $jQ.Q� _ $
Number of fix�tiares @ $15.00 x $15.00 = $
Number of fixt�res @ $25.00 . x $2g.dp = $
Number of fixtures @ $35.flU � x $35.00 = $�
State Snrcharge = $ .50
. Total = $ 3,S 5b
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTII, EROCESSED
I hereby apply for a building permit and I aclrnowledge that the informarion above. is complete and accurate; that the wvrk v�ill be in
conformance with the ordinances and �odes of the City of Fridley and with the Minnesota •Construct3on Codes; that � understand this is
not a permit but only an a plicahon for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case � all worls�wAhic�quires review�nd approval of plans., . �
SIGNATURE OF APPLICANT
City of Fridley
Building Inspections Departm�ent
6431 University Avenue NE, Fridley, MN 55432
� 763-572-3604
FAX: 763-502-4977
0
�uilding
�nspections
763-572-3604
-�.a� t � � �
iTE ADDRESS L'% �7 O
= rIIS APPLICANT IS:
BUILDING Permit rTo.: d vU�I�-tz�'�
RESIDENTIAL .APPLICATION Received By: � _
CITY OF FRIDLEY Date ��.'Q J�% `�► �
YOUR E-MAIL ABDRESS �� C� t S GC� .0 � C! l�' � 0I �� y. P O I%rJ
�no Sf /V�
❑ OWNER �ONTRACTOR
?R�t ERTY OWNER/ N,�: 5 c� n el � a S 1�3 !
TENANT ADDRESS: �f '� o I� v A v s�f'
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROFERTY TYPE
PERMIT TYPE
�E oF woxx:
N�: fHD At- Home Services, inc.
sTa,� Ltc 2690 Cumberla�d Pkwy, Ste 300
,a�Dx�ss Cumberland Office Park
PHONE Atlanta, GA 30339-3913
❑ sINGr� Lic# 20268257 Ph. 763/542-8826
❑ TWO FA • �
A�_z� `� S K 3 �
3Y5- (.oU�
CITY STATE ZIP,
❑ BASEMENT FTNISH ❑ ROOF ❑ DRAIN TILE
� DECK O SIDING ❑ OTHER
❑ SWIMIvIII�iG POOL
�ESCRIBE WORK BEING DONE:
>IZE OF IMI'ROVEMENT
1UMBER OF SQUARES
�ARAGES
�ROPOSED SIZE:
'ROPOSED HEIGHT:
w
0
0 HOUSE &. GAR.AGE
❑ ATTACHED GARAGE
O DETACHED GARAGE
�VIDTH HEIGHT
BASEM�TTT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed flaor plan
3. List of structural members to be used
���
Ft
.IDING FOR NEW CANSTRUCTTON INCLUDING DECKS,
] Vinyl ❑Soffit ADDITIONS & PORCHES SUBIvIIT:
7 Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures
7 O[�er ❑ Fascia and proposed project
2. Two sets of construction plans
VINDOWS 3. Energy Calculations
.1 EXIST'ING OPENINGS�qYes �No �ATION OF WINDOWS
>R FOR NEW OP£NINGS-DESCRIBE SIZE OF (.IU T A� ht_. f�Pt1e p1 I/. �t /n� 1�� L�t' O 0 M
rPENING CHANGES & /
YPE OF WII�IDOW TO BE INSTALLED NUMBER OF WINDOWS Q
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MA,TERIALS:
(LTSING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOS VALUATION $ R��� OCCUPANCY TYPE
ermit Fee
lan Review
urcharge
ire Surcharge
�icense Surcharge
AC Charge
:urb Cut Escrow
.rosion Control
ark Fee
ewer Main Charge
'otal Due
$ d
$ Q�
$ .00
$
$
$
$
$
$ t��-Q�
See Back Page for Fee Schedule
6S% of Building Permit Fee
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Canservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMTf-NOT VALID UNTII, PROCESSED
hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in
�nformance with the ordinances and codes of the City of Fridley and with the Minnesota. Construction Codes; that I understand this is not a
:rmit but only an applicaiion for a permit and work is not to start without a permit; that the work will be in accordance with the approved
lan in the case of all work which requires re ie andapproval o€plans.
GNATURE OF APPLICANT � r�:� PRINT NAME �/ � 5�/ � n lc DATE � l� l� d l
Page Z- Building Residential Application
BiTII1DING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or
structure, or for any ad�ition to a.ny es�isting building or structure, or for �amy al�eration ar repair
to a.ny existing builda.ng or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herei.n below set forth and in the manner herein
provided to-wit:
VERII{TCATION OF FOUNDATION
Pemv.ts for construction will be issued a minimum of 24 hours from ihe time of application to
allow for proper review of proposed slructure and of the construction siie.
A Certifica.te of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Hou.ses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Frid.ley, MN 55432
763-572-3604
Fa�c: 763-502-4977
Engineering WATER AND SEWER PermitNo.:2�c�-E,�c�
c���=5��2-3551 pE�IT APPLICATION Received By �
763-571-1287 fax CITY OF FRIDLEY �e�'�
EFFECTIVE 6/9/09
APPLICTATION DATE: / "' � � `— � —I YOUR E-MAIL ADDRESS: O� � `J IltdC�O��,sz CRJ ���/�A ��l , C ��
THIS APPLICANT IS: � OWNER ❑ CONTRACTOR �)
JOB ADDRESS: ` 7 �I �i�� r ��1 �'J � � �% i �/' � � �� � p
NEW CONSTRUCTION PERMIT# (IF APPLICABLE):
PROPERTY NAME: !ei �t ,� �s1�G� � 'C' G�PitC, � G?.�o f �
EN�1�1't'� AnDxESS: 3�i / r�v� �' o� �'�% e�. CTTY ��'T /�' � STATE�ZIP .�Sei3�
PHONE: �, r � "c�� i� '' �( � Q �O
CONTRACTOR N,qME:
SUBMIT A COPY OF �DRESS: CITY STATE ZIP
YOlIR STATE
LICENSE WITH PHONE CELL PHONE:
APPLICATION STATE LIC # STATE BOND: EXP DATE:
1. Narrative/written description: �/� � /�� � �� � � C��
.c o�h Sef.yP �(eiL� � T
(�PO' � �I� �/l f !°� �. (._ �Sl r ^� O - ' P�
.e� � �o f� � ace de cc � �ls�� �� ,f��.
2. Please attach sketch showing curb line, utility line, building, etc. with distances.
PERMIT TYPE
❑ SEWER CONNECTION PERMIT $50
O WATER CONNECTION PERMIT $50
❑ WATER LINE REPAIR $40
� SEWER LINE REPAIR $40 �
❑ ADD STATE SURCHARGE $.50 9 ��
� SAC CHARGE @ $2000 =
°T � .
. OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING
NEW WATER METER COST — SEE UTILITY BILLING
SPECIAL ASSESSMENTS — SEE FINANCE
WATER TAP — SEE ENGINEERING '
NOTE: WATER METER REPAIR, INSP OR SHUT-OFF / wEEKENDS & HOLIDAYS $125/HOUR-BILLED
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a water or sewer (new connection or repair) permit and I acknowledge that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley. I understand this is not a permit but
only an application for a permit and v�york is not to start without a permit.
SIGNATURE OF APPLICANT � V �°�� PRINT NAME: �� �I �� 5 � ��/S� DATE: / ` � G — D �
APPROVED BY: DATE: � � �� ��
COPY G T:❑ UTILITY BILLING (only if new meter) ❑ PUSLIC WORKS 0 ENGINEERING
� ��
�1 � �
0��6�� �
'� � � F C ��e
City of Fridley
��� ` Engineering Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3551
FAX: 763-571-1287
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Build'ui�
Inspectians
763-572-36U4
76�-502-4977 FAX
IY�CHANICAL
RESIDENTIAL APPLICATION
CITY UF FRIDLEY
unTE -- ,�� �... -_ Yc)ux C. L AAnK�.tis _..�/ G�%i� �,,j��
J /
srr$annRr�,s . .. . ..__ . .... ---
TIiiS APMULANT G4� 0 UWNB[i t:()N'11tAC1'OI�
PROPElil`Y NAME: •. � Gl �I Ci =�dh S �� __.
UWNER/ A[�DRCSS:�� l� G�--� 'i��—.. ._ C1TY� G! � ...—
TCNAIYT /�
PHC)NE:_ —. -/ �/
�. � i ��
sy:
�'_ �
c.vi� � iwa. avn CUM!'ANY NAMh::__ L! Y �J, ���TIY,�vI, v�.a� ,r�ip� ��rrr�a.; �
-• -
SURM�T A CCri�Y OF c�TA�7' rt KsqN: ,.� d�11 Li 2�_ J .. _ ..... .. ..
Y(>I IR S'1'A'fE !Y'A'I'E uGL'-NSE n EXP DA'1'K.. ... _ ._ .
!J(:�NSEWITH ADDRESS:_�.J�„�,���'�! S}� Gv� _._ _ C11'Y� .._ S'fATE�/..I
APYLI(:A'fIAN PIIONE 7/03__.�"%LI ��i �� hAx _ "71o3'v"z%�/,r ��
PEItMIT TYPE
TYPE OF W WtK:
�INCiLE FAM11.Y O TWO FA.MiI,Y
DiJL�W �!?PLAC�NIWJT
pFTAII.. 'D DESCItIi''['ION C)l�
-- .. �
❑ Tf�WNF10USF
O ALi'k:ltA'f10NRtEM(�nP.l..
x��s nac e,�E�► c�N ��a.00 �a rtxn►a�, Ex �r r wliBBC n�o�rt.a. �x•��i�c�c: �t, DICATC Ttarni. NuM�r,a br E
Fquipmcnt I�u.-tn11eJ MFCi: 8'YeJ MUD�L: �,�q 3��i�'� ti V..1:A
MfG• MODeL: __ SI[.l'JI
MFU, MQDZL� SlGtdl
�NC:9�s.00 FIR�t�LALE(OAS)S1S.00 � (�A:� ItANGCJO'
_Atit TO A!R F7if:NANUEER $15 f1ItEPLACE (WlH)U) 535.00 _NEW (iAS (�Kll
BO1L6R $35.(�l1 ,_FURNA4K ��5.00 GAS lW!'c MTl1
4HIMM3Y LINEIi $IU.iKt _GAa uRYIiR $10.00 _�POl1L UEATEIt
� '�_ ' " ���.� �.� ...... ..._ \/OA1T11 A •IYtO 1
I1S IS AN AFPLtC:ATION FUK A PGRMIT•NC)'C VALIA UNT1L RRUL:FSS1iU
��J�. � 0 M"� r�:i i°r►,wm�
� y foc a buildiag pennit and 1 acknowlc�ige that the infonnaticm �bove is ccsrnplete and accurat+
confnrmance wiCh the ordinanaes a�id c.�udas of th� City of Fridtey and with the Minnesota Cunseu'uction CodE
not a rermit but only ar► opplication for a permit and work is not ro sKart without a permit; dibC the work will
approved plan In che cra� of �l] w�rk w' h req � reviaw �nd appraval of plans.
31(iNATUIZE ON APPLtGAN'1' __,.. . __ __PRiNT NAME LJ I I I � Ql'1 ._ ._l)
T�-- City of Fridley
Building Inspect�+ans Department
fi431 Ui�iversity �venu� A►L, Fridlcy, MN 55432
763-STZ-3604 F/�X: 763-502-4977
i ��� w
iN SIU.tI�
sio.00
io.00
tt�at d1e wurk wiU be in
thcitt 1 undet�tand this is
: ir accordanc� with ti�e
�v � .L..�
�d WHSS : L T 600Z Z L 'un!' LSZ Z T LS£9L :' ON Xti� A31Q 12� �0 J.l I�: WQLI�
Build�
��.
Inspections
7 �fi3-572-3604
763-502-4977 FAX
DA7?? . l S- �v
srrE,annxESS �
THIS APPLICANf IS:
PROPERTY OVi
TENANT
�
SUBMIT A COPY OF
YOUR STAT'E LICENSE
PROPERTY TYPE
PERNIIT TYPE
OF WORK:
�•��
BUILDING Permit No.
RESIDENTIAL APPLjCATION. �Receive�t F
CITY OF FRIDLEY � Da� ,�
YOUR&MAILADDRESS
�• .
❑�
rxoxE ( �c ,�
STATE LICENSE
O TWO FAMII,Y/NEW CpNSTRjJCiTON
■ : a ia � � . �,� .
■ �'N ■ Yu� C
� Y'./4�I�ul
N .« !
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a�.�.�
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■ • ;1:�'
❑ NEW HON� CONSiRUC1TON ❑ ADDTITON
O MAII�TENANCF/REPAIIZ ❑ REMODELIN(3
DE'.��RIDE WORK BEINQ DONE; ' .
SIZB OF II1�ROVRNIENT �� �� ��
pp • S FT
NUMB OEI� F S UARF,S j�)�� ❑ HOUSE ONLY
Q �"' °� . �HOUSE 8c CiARAaE . �ASE�1T �tEMODEL?NQ crJgNAT
G-� U O A TT A C I� D QARA(3E 1• � 8 Floor P l a a
PROPOSEI7f SIZE: O DETACHHD (}ARAGE �� �P��d Aoor pl�
PROFOSED F�IC�`HT: 3. List of straatuial membe�a W ba used
SIDING
❑ V'uryl
O Ahm�►um
❑ Odiea
�VIIVDOVVS
W EXISIINTQ OPENIId(�S O'Yes ONo
OR FORNEW OPENII�Tt9S-DFSCRIDB S7ZB OF
OPENIN(} CAANQg.S 8c
TYPB OF. WIIVDOW TO BE INSTALLED
ALL FEES ARE Ra.cFn nr
JOB
Plan Review
Fir� Surcharge
Surcharge
Lice�se Suu�oharge
SAC�ge
G�rb G�ut�Escrow
Brosion Contaol
Park Fe.e
Sewer Main Charge
03offit
❑ Trim
O Fescia
LOCAITON OF WIIVDOWS
V.
nv TtIE C�3T OF
FEE 3CHEDUL�
FORNEW CONSTRUCTION II�TCLUDINC9 DECKS,
ADD1TiONS � POR c crmn�
1. Site P1edSurvey ahowing the axisting ehucRves
� �P�Po�pm�n plans
3. Enwgy Calculadone
.G�:
TION $ /od � �Q ., 'o r-� � � � ,' - p�COpAN� TYPE .
'i %a ,.�� $° _ See Back Paee for F�e Schedule
`''� $ ' 65% of Bwlding pe�it Fee
'�� �� $ .001 time� the total job valuation
\ �� $ .O(i05 x P�mit Valuatian Nlmimom $SO
'� � _3� �$5.00 (Stata Licensed Resideafii�al Conhactors)
�$ $1825 per SAC Umt (Plans to MWCC for determination)
$ ft+6ft= ftx$21=$
' $ $450 Conservation Plan Review �
$ � Fee Determined by Engineering .
$� ` Agreement necessaryr i) Nan Ne,�ssarY i)
'$ _ iVlske checke PaYableto• City of +I5ridleY ' Attach
THI5 IS AN APPLICATiON FORA PERMiT NOT VALID UNPIL pgpCESSEp
I hereby epply for a bw'ld'mg permit �d I aclmop�dedga that the 3nf�
of die City of Frldley and wi� the ���on ��
e
peamit oa srte; that the work vn'D ba m rden ydth d�e ap�mved
P��`I1
� APPROVED BY
�mdeisland thia is �t�a �: �t the work wiD be in conformance with the ord�ances end codes
�1 the casa of aU work � � HcaHog o f� aad work is nat to start wiehoue a
% �J
��� PRINT NAN� DAT� '�
a
DATE
��