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From: unknown Page: 2/2 Date: 6/29/2011 427:12 PM
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3. i.ist of etn�emral mem6cts to 6e vee�
FOR NEw C�TiSTRUGi7oN IIvC[.LTDING DE
ADDI7TON3. � POR£�S 5[J�A�LL:
t. Sito PIsalSwvey ahop�ing ihe qci�ting
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3. Snex�y Calcuiatioaa
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$.._—. .'Y,�. G?J Sce Back,l'�ga fatF�t Schcdulc
$ �SS"/o of Hu�lding P+etxniC Fee
� � •�0] Cu�es tl�e �1 job valu,alion
$ .0045 x Pcrmit Valuativn Miniz�u� �,5,00 '
_ $ �1V $5.00 (�tste Licensed Resi�de�o�,tipl ContraCWrs)
�—�.��-. -- $223U' per SAC Unit (P1sms to MVJCC for determfaati<m)
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$ $450 Consecvatioti Plan Review
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• TPIIS IS AN APP'LICATlC1N Pvx w fiBRMCl-NU'1' vAi.u) U�'A1L kKt�(;�y��
I hereby apply #'or a bu�t.di,zxg pen�z�.it and I acknowl�ige that ti�e information abave is co�uplete an,d accwrate: thst thio wulic will � in
cmo;f.vx�anance with the ordin�anees and eodcs of thc City of Fridley and witk� tke Minnesota ConstrucCion Codes; that I �md�rat�d �Zis is► ot a
per�nit but r�niy an application for a pesmit a�d work is not 4o start without a pcnnit on site; ttk,tat the work wi� be in accvrdxnr,e wi� the
a rovcd lan in the case o l3 work review aqnd: 1� /� I
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