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AF - 47321� City of Fridley, Min�n_ - 113 � 8 6431 Univeraity Ave. I�. E., Minneapolis, Minn. 5543 BUILDING PERMIT ��@: - jj.nrr,�h � 1 A]9 p�; Richard A. Ma.ras g�� Tri-Co Builders Inc. Add�ess Address 755� Van Buren Street N.E. LOCATIOIV OF BUILDING NO ���� Street .TA -k on R�g�et N_F_ Part of Lot i.ot - R Siock 1 Adaition or Sub-Division e o Ma_*!�x 3rd Addi.tion Coraer Lot Inside Lot � Setback . �p. � Sideyard .__1,.7 �& 1!� � ,q��/,�E��� 873_44 /��������/ 876.44 (gQprox.� Wye Top of Footing DESCRIPTION OP BUILDING To be Used as: Dwelling Front 29 � Depth 40 � Height 20' �. � 1030' �� Gara�e �t 22' �p� 22' Hei�t 10' �, � 489' �� 4890' 7+ype ���� � oo d Frame �, �� fi19.S8?,s00 To be Completed Au�.• i-s 1972 Stipulations: Provide verifying survey and provide a hard surface drive. WATER LOCATION: 10' North of Sewer Service gEWER LOCATION: 159` South of Manhole In considerat%n oi the issuance to me of a perrmit to construci the building described above, I agree to do '�he prap�sed work in accordance with the descrYpt3on above � forFh and ia comp� � ce with all provisiona of prdinancxs of the dty of Fi3d1eY• /� 9.79 St�tEe Surcharge Ea consideration of the payment of a fee of � 48.0� , permit is hereby granted to Tri-Co Builders to constritet the building or addition as described above. This permit is granted upan, the express condition that the person to whom it 3s granted and his agents, employees and worlunen, in all work done in, around and upon sa:id building, or any part thereof, shall conform in all respects •to the ordinances of F�Ytlley, Minnesota. regarding location, cottstruction, altera.tion, maintena.nce, repair and moving of buil�ig8 o�t1�,��in � city ]imits and this permit may be revoked at any time upon violation of any of the provisions oi Bafd � � — �Pecto� �r.aR�vrE BELISLE NOTICE: This permPt does dot eover the eooatruetion, inatallaHon ¢o� wirin8. P0��8� 8� beatinp, sewer or eereter. Be wro b sea f6s Building laspecta� for separata permits fo� theae items. r� ,. � � I APPLICATION FOR RESIDENTIAL, ALTERATION, OR AllDITiON BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA �� 3 �G�1 Oidi�TER' S NAME :_ �� � %�:' � � � �i4,�r*" Q � BUILI2ER: � e� -� �,��rs , s°v�� ADDRESS : ADDRESS : �s��S �`��> %�vss e�� . �� � / NO:. STRELT: ��'e,%��c�:v .�� LOT : � BLOCK : / ADDITION : �c � �� �,� ✓�, d y� 3 �`°� % �,�' CORNER LOT: INSIDE LOT:_�_SETBACK: ,� o' SIDEYARD: Appliaaa� attach to thie form �io Certificates of Survey of Lot and proposed buildiag location drawa on these Certificates. HESCRIPTION OF BUILDING To Be Used Ast .���✓,�/� F�: /� Froat : �`� Depth : `/� Height : � � � Square Feet• /o � � Cubic Feet• °�� �•oo-� ��c �roat. '�-�- Depth • �� Height • Y -°° Square Feet; �/E� Cubic Feet: -���' �` -� `4 --`� : 1�pe of Qonstruction: �a..��� Estimated Coat: �O Ooo —° To Be Campleted: / I�u� i� 9 Z l�i S�� The undereigaed hereby makes applicativn for a permit fos the work herein epecified, agreeing tv do all work in sttict accordance with the City af Fridley Ordinaaces and suliags of the Departmeat of Buildings, and hereby decla�ces that all the facts aad represeatations stated in thia application are true and correct. DATE: �- �' � � P � 2- SIGNATURE • O �,�,,•-� � � (See Revexae Side �or Addltional Information.) . �� �' ` ' 4 t � �. �- r , �i p , , - ,�_.� � � l �_ �;` � `� � d� � `e �a- - � � � � � �,�� f ? � . �`" � �e��,��� � � , a BUILDING PERMIT FEE SCHEDULE SECTION 2. The Iaspector of Buildinga shall, before iasuing permits for the erectioa of any building or structure, or for any addition to any existing building or structure, or for aay alteration or repairs to any existing buildiag or st�ructure, upon application therefore, require the payment by the applicanfi �or su�h permit of fees to the amount herein below set forth and in the manner herein pzovided to-wit: iJNIFORM BUILDING CODE: ljrpe 1, 2� 4-$2.15 for each one thousand cubic feet, or fraction thereof, in such cubical contents. �►pe 3� 5-$1.85 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpoee of computing fees for building pe=mits, the cubical conteats of any buildiag or additioa, is determined by �altiplying the ground area ccvered fram a point eix (6) inches below the floor line of the baseu�nt or the cellax to the average heights of the upper surface or to the average� height of the roof surface of the me.in gable of a pitched roof. For repaira o� alterations to an exiating atructure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) oa fraction thereof in the Cast of al� proposed work. Ia ao case shall the fee charged for any pe=mit as set forth in Section 2 be leae than $5.00. � VBRIFICATION OF FOUNDATION NOTE: Permi.ta for eonetxuctioa will be isaued a mini�um of 24 hours from the tia�e of application, to allaw for proper review of the proposed stsucture and of the coastructi.on eite. A Ce7�tified Survey o� the lot, ahowing the loc�tion of the foundation, once �t ha� been constzucted, wil.l be required before proceedin� with the frami�g. CERTIFICATE OF OCCUPANCY Appl�.catioa for a Certificate of Occupancy shall be made ten (10) days priox to the u�e or occupancy of aay etructure for which a building permit has beea i�sued; and said atructure shall aot be used or occup�ed until a Certificate of Occup�cy has beea ieaued. ' �� = . _.. � �,� + � r .a., 3 � „»� � a,+�� r� r. . � � �� � �� �, � t N �� v:�. '�"> �.� �� �.;�' ,�. : �,�. � � _ �.. �� � �« : - � . � d .. . , , ::�- -�� �a �, . , _ ._ , - �� � , � , , �; � ,� . �r . - 5� 3,r.�-� . j� � '�,.� ,. �. . . �E _ . �, twai►l �x�r�' . : �.�.������-� �; �- � . (odStr�r� ��1�t.� � � EN � i �J�ER��i ��C. F�;- � �: tiv►� b �k.►�ool , � .l��6f , �� -- Enginee�s � Surveyc�rs — -� r ce!"��a�i:if.ls �►� ��1 ��: � I,�,i t�r�+�' � ��/ V {� Z 0 � X a � � � I M u J 7 1 � �s � � - ,�. ]X^�. 5 K "v . � ���, �� ..:� �,. ..�'. p . ,..; . . .-,.j�: � �=� :�� :.:. � �� . . ;; :r� � o pEN4TES IRON �DENOTES DQA11iA4E AND V?1LITY EA�EMENi ��- �; �OT�B�OCK �! MEi.OQY MANOR 3R0 AOUITION ��2 �f> IINOKA COI�T ; �' /lir►� � iN�e,F �s rs w*w rrd arrrt�cf rr�rt�+ion �i'o s�r'w�/ �'�t iww�4r+rs �Nr riwr ri�avrir� irid,�% _ ,�t',1fr,(�ot,lir� �i'�,�► �11 r�s , �nrwv , .a�.N �rsiJ�k a�a�a�ai�+wrts , �'.y. � r ��:d ,i�ud. As su►veye� �ly �a f�,_..�-_- i�r ; �('_��„#______— �.n r�a. St/�dU�28lUV EN6�KE�R�Vl3 , �VC. � �� .,,,,e �� ,.. -- _ 6r .fbv� �Nr� } x Scack: I'� 40 l�y -!^%� .f`�-�`'�'�'���.�.,,� �. ;.;� � � �` • , .� ,,r� ��.: � C �� >> � � ���� � � � . _ w . . _,_,s �"���.�.:�� �S L �� o � � ��c1 E� o r� , 1 p F ��. � . / � � c�. ��� �� 8' $ o . � 3 , `f �� �'� v'. — � 7�. 4i � r,� �E � , _ $'�6.� �.� �ax. �'� �v� y o DI� T PP �-�,,Z L�c � �-r o,� L� � /0 ��I ♦ � ��C ��� v �c � O� � • , �-. l�1 � -�y5 . a� ,; o ♦ . � � . �� � 1 i` loed Ylanniog ����/��� 687� Nighway',NO.bS N.E. tand Surye � • • Mi'nnea olis Y.� ��C p � Sbits Testing ���e������ • Mine. 55432 Ci�fl Edgine�riag Tetephaee "784-6066 Mvnietpai inginearieg Aroa Coda 611 . Engine�rs & . Surveyors Mortge,�e Loe�n . Survey for ���`�� ���L.�}��� � � � i�� a� !�"�' �� � � � � � • + �% � � � � �• �+, �12AQ _ 3°� 3L0 # n . . . , , .� � $• CaSerryeY��"f u�1d@Y: � ° Construction 7 � r IN �v 1 I'�..Oa � ^'o :. � �� • � ' � � � � C, (`�l � ' . ��� �� o �: i Q � �,:� � j � � ., ` � '' `t{►..' , - J ,�l fii � .,�:,,�� �� 6 � � ,�"���. . , Scale:l inch=3C`� �'�e�- ` �: - , ► I' +: � -. �Q� � �.� 1_C��� 1, � ������ �A��� ��° �D��a�� � � � � _ . cou�+y � � ����� Thib 3s a trde aud wr►acT representofi.on oi Q wrvey ai the boltttdaoies :of= tFre Jqnd obbve i�,ascriber9 and of.lhe - � la�trtiifn,o! oIi bMitdings� if nny� ther+eoey'and elt visibl�i encrooe6menf�� if etny� freela b� aa� said ipnd. T6i3 sur�r.ia �-`: en�de �fniy in <wtneet�lon wFth o martgpge loan „ow beieg, plaeed pn tke pcopertr oqd wo IPaliilitr is oss6th�d ' ; �: . ..�^ , , _'�xcepf °�q ibb gdWei� oi 3i�eb morRd�Be or: ony athe• laterest ocquired by ,tke reosoe Of �ush etibtfgvge. It ia. enderstoed'�nd ogreed no me�nupae�+►s h e been placdd tor the puv�se �f eatal�IisAirtg lo� li�a� ar.bpon�larr � � cqtKd�s. Da�ed ' fbis�,datr of�A. 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Cselin� Roo� r Kend . � a t es o �9� 9 oom l.eageh ldidch Hea��c FI.� R�� l�e�gt� i�led�6a ����� � �� / ` / �/indaws a� Dooear-�rackm�e amd Aeea �imdo� and oora—Cracka�e and Aeea ' Y1dth Helg�t No. oe Llncal ft. Aeea �Vldtb He1 No. ot L8oma1 [6. Aeea � 1Ve. ot paoa o( ane Ilghte o[ craeK •• t!• No. H oY I tm ot e• •« �� p � e ) � _ . � � l� Btu l�ltratioa -� �' Glaas �p. raa19 IdeB eYp. wall Int. wall Ceiling Flooe Total Beu. Requir aq. ft. E.D. . or sq. ina. W.A. I.eader aeea &l.� / /� m � Length ,� Width Q6/indows aeod � a--Cracl�age aad Atea 1n61tration Glasa -- Eap,. WdI� E Net exp. wall ;` Int. sball Ceiling � Fl�r Total �tu. itequire . ft. E, Fl. Win and I ldth H Nn_ A[ DYI� OI �=1���. / ������.�% '� �' �/' ��■������ ; ������. ����� �������.� �C�I �%!= IIGi c�y�..r.� i. �� � i'-��)-� �c�s ..��!�/�G ��� �� •- �.-��-�/ 1 �) �, .�� , � :����� _ y, • �/"7 Ind'iltration �ae� �. watl -- (elet eap, wal In� wall Ceiling 1°loar %tsl �tu. .� -._'��a�;:� or a�. ies. �I►A. o� In�tltratio�a ' Glas� Exp. w�ll x Neg �P. ,,,�u e 1nt. wall �eilin� � F'loor T'otal Btu. Eiequir d aq. h. E.D.R. or eq. ias. Q/.A. d� Fl.l J 1�oom I l..eogch ��Ii Win ows and Doors-�r�cka�e and l�tea q,�Qtb �o�se� rto. ot L1aea] tt. / No. � D`A� .�� 116ha ot era �. In6ltratioa Q C,lass � F�cp, rwall Ne----- - Int. w�ll a� Ce Floor °Total �tu. �Vie�dowa a�d � Wldth H No. � Dan• 04 I�tration CJasa Fsp. wali a Net e:p. wall Ia�. wall -CeiGng Floor Total & .0 - �rea or eq. irie. W.A. admr aaa� � � l.ength �1�lidt� sCrael�ase md A�a �� /: � . .,� �@ s-:�s�.�� ` ' ---- -- r�*,�' �, E`�, c"R '" 19 e'-� e :s�l j� ,� �,«. <1 i°� y,�'`A� �?'�s,,.'",�,� j�'`� �,rx�,s�,,.y�'', Dr� �a��`��`�! �s'�` � '4' �` � e //� i�EAi' LO�S CALC[J1.ATi� DEPAItTt+�1EAiT' O�° ���I��ECTIOI�J � e _ ��/�°, Qieatherstpepe A Guide Coaetruceiaa Ido. lae�alaei�� Window� Doon Refers�ece Out. Weq Int. Wal! Ceelie� Roo� F1 �►� �°"� � d— 0 19_ oom l.en�th �idth '�ieight F�.) � �a� �'�` �1��� °�' �vla� e8h811dHeiBAt� Neaotka�ca� aid4�rt Aro4 �'mdowe and �ra�--Craeksge a�d Acea � � Wldtb HelBht No. o¢ Llnwl tt. Aeu N a e ot Do 116hte ' ot e No. �na at 11 hte o[ e q. a 4•" 1 o lo � ������a �� � u 1Vet e:p. � ° ln� wall � ce�fi�e Flaor ...=�..�. ,� �c� . � . , �►�� �, IIC� _L./� _ . . . ��: .�. ��������r�yN 1��/;�/�.�ro , , . i�-■�'1��I quir E.D.R, or c�. ing. RN.A. a�r mrea �. �Z11 �.CR�1 �� �I�i}I .nr�nw a Pf---CIaC�S2 iila �C8 n C Iu5lera¢ion G1w Esp. well � Net esp. wall Int. wmll Ceiling Floor Tota! Btu. ' � I ;/ ( . or sq. en�. �V.A. l�eader area ' T/� ae � Lea�� Width �� and � racka�x uad Area � Nef�b No. oL Lloeal tt. Area � � o� p 8 If�hts ot ' ' � -� �=:� 1�61tra�an � ` ` Gleu F�cp. wali 1V�t e�p. w.11 � lnt. wall �r — � Ceelin� ilo�r fotal �u. eq. �t. E..DR e� eq. eea W.�. �,ea�r area E �i � . ��ai'� 1 \ r,����� l�� , �� ��� r ✓ '� � �' =' � J•, 1• ����� s „�� ������� M1 � � .: / ; Infilerntian Glaea �p. wall Alet e:p. wall Int. wall Ceiling Floor ` 7ota1 �e . �� I e�� Windows aaad Infiltratioa Gla�a EsP•— wall � Net eap. wall in� woll �_____ Ceiling Floor Yoca! �u. � C 6� ''' �°' / 6 or sq. 6ns. i�l.e+. I.eadee area � I l.ength Q6li�b —Crnekaae a d �erea 0 . � .s �r.: f �� ' �� � � � � �o r o �� :o : � • M M : A . �' � , � ; � ' � � : . � � �..� � �, � � M A � m '° � � G� � w n � � 7 E " �� � � x � �f � � � � � � w '° � t� 8 � ..mf°. 5 � � � o � R °' ° • f° � �' ►. =� • o � •, c C' y� y 7�1 � � p b • � � � �� a � $ � ; � bd . . . � � : �. W . tn � � . : °° � : : . : • . . � . . . . � . . . • � . . . . � . . . . � . . . . . . . • . . . . . q, � x l �x 0 0 M il N M k k �e k if AC 8� 8�8 b� 8��� 8� �. �«�« �.�� "� �o � I I�.� �� � �� � �� � � � � N � � A � D � f'D— /� � � � � m C r �17 � fz9 E fl. � � � 0 0 9 m o� 0 �t �� ...�� � ' ... ■, , � .■.�1 � _ ■��0►� • ■■■�, � ����\ ����� � � o � � � � � M O. � Cn y M � » � � �. � � g �i » � � � � �B � 4� \ ��. . � � �; � �'1 � , �� � � � �m ��'�I w�m a.osRs u�u�s r►rN � �� :�� w� ra►rs ��. fa/HT. SMIrI�. FLOO� OMINS GTGi eASINS AUTO w� � � � � c�s OPENIN65 .. :. � �� �� � �. a � a �� � � � � M � � O �� � � � � � � a�� o � �v � M � � 00 � � �6� � 1�r 1� � � � � � � � ? � � � � m � �.a��a� » ���� ���� � � � � 3 '� � � �' � DC � �� d � A � � :: � M � � � `a` � � �' � � �. � �' d �- � � � �� � � 1 � � � � ��" sue�ecr PER City of Fridley � 1355 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � RECEIPT NO. � ; L __��_ COMMUNITY DEVELOPMENT pIV. r � � PROTECTIVE INSPECTION SEC. 1 . � � � ��"1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OP APPROVED BV �----� • ,'� 612-580-3450 910-F15 6 � � JOB ADDRESS 7371 Jackson Street N.E. 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. S 1 Melody Manor 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard Maros 7371 Jackson Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Dean Bartl.ow 4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE IdO. 5 ENGINEER MAIL ADDRESS Z�P PHONE LICENSE NO. 6 USE OF BUILDING Residentia.l 7 CLASS OF WORK ❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct fi.replace 9 CHANGE QF USE FROM TO STIPULATIONS - TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATINO, dENTILATING OR AIR CONDITIONING. COI1Cr2'te THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDEO OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �. 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 SPECIFIEO HEREIN OFi NOT. THE GRANTING OF A PERMIT S�-�500 y� .%S DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �`9 � OO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECKFEE TOTALFEE $9.75 SiGNA7uAEO CoNT ACTOR09-�UTHORI2EDAGENT (DnTEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT i � � (� A �i� ,� �. ' r � - C� � - % � - 2..�(.1vC, �� ��Ld'ld ��' � � Y7�0 -�t -� n � SIGNATUREO OWN RIIFO NERBUILDERI IDATEI BLDG INSP f]ATE F,. AP.PLICATION FOR RESIDENTIAL, ALTERATION, OR AllDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA ow�x's r�:`�,� /;�6�:� --�! ��,� r����BUILDER:��� r-� � �- %���c�° ADDRESS : ��.� / / � .�� m � ADDRESS : � NO:. .�'� STREET: � � � � 1��� sv r7 ' •S l��' L � � l ) � LOT : � BLOCK : � � ADDITION : �!' � � � �!�%�:<.�.�.�c, � CORNER LOT: INSIDE LOT: � SETBACK: SSDEYARD: Applicant attach to this form Two Certificatcs of Survey of Lot and proposed building location drawn on these Certificates. HESCRIPTION OF BUILDING To Be Used As: � Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: �ipe of Construction; �,,,��-s-�_�+1z�C.� Estima.ted Cost: �S �� t� C`� •°�) To Be Completed: � Y�t� �� ; . The undersigned hereby makes applicativn for a permit for the work herein � specified, agreeing to do all work in stiict accordance with the City of Fridley Ordinances and rulings of the Department of Buil:dings, and hereby declaxes that all the facts and representations stated in this application are true and corxect. a %��% /� ,f/ �/� DATE : � ��� SIGNAI'URE : ��� �1 � ,� C�f Zl� G�° �i/ - f „� �4 i � � ' � (Sae Reverse Side For Additional Information.) �S'Oo �C /SU L � .� _- , < �,Oo�OUo S°�vo 0 � �f', O G �2�r►�T - •7 S � _ �� /, �u . ,�, , � ��. _ �� BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Bnildings shall, before issuing permits for the erection of any building or structure, or for any addition to any existing buildi.ng or structure, or for any alteration or repairs 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: UNIFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic feet, ar fraction thereof, i.n such cubical cantents. Type 3& 5-$1.85 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area cavered from a point si.x (6) inches below the floor line of the basement ox the celiar t� 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 a,n existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. � Tn no case shall the fee�charged for a.ny permit as set forth in Section 2 be less than $5.00. VB�IFICATION OF FOUNDATION NOTE: Permits for construction will be issued a minimum of 24 hours from the tiane of application, to allow for proper review of the proposed structure and of the constxuction site. A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before uroceeding with the framing. CERTIFICATE OF OCCUPANCY Applicatiori`iox a Certificate of Occupancy shall be made ten (10) da,ys 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. ,� �' ` - ., 7 � � M t� a � � � H � ro � � H H � N J N 0 w� C) t' d '� p � H fD H . ,� � hf � H '!., ro . • � w °� � ro o a � � � � � I � � H •1. N M a n A � H 'y N r .� o � O � O �..� z � y�MY L7 L� O r r� 'r �-+ 'r r ►• M H/•� cn cn r '�tl H ,.'7'., C'i 'rJ U � � O � Y i'"' l7� O N C(: C W r'• H Y Y% •-1 k 7.7 i7 �N"' � Q r-� r-+ �-C. W(�L N�'" F-' ['1 W M W H W rt %%% H N W tt % �c> 7y O 7� Q O f� a� VI Li Li r-r h•• C� �b 1 .7' 1 ;Y ,f ��• G 7 ' ' G�+ (/� t/� % W� O„� 'i7 in �S lai. O �• � P� y. i ✓ r-. �fJ :-1 F'• M t{i � {1 w L r f�. N �cncni r� w r �a ro a N M y�-3 C: « r� tn td w� • •�. 'tl IT1 1-1 Y�:, � M� c� o W ra-� O o ro rr (n N r r v, N o W N� rr c�i� �iOS, c�'. � o ~'a c�i °o 0 0 � 1 om h�°o ro K °o°o ��-� - oN � �f � �' Hotr3o y o r. c: o � �y � �' O �t H o '° C a ° i � y �h c: r� �: a ry f � o� a I I I w �n r a y fD xxx � w � ��� N N N � p F� !o O O Q O� �] �P N 0 0 0 0 0°o °o 0 0°o `-� r �� N ry� 47 p h1 �(i 'U �t i j� W W W W N N �� N N y h fn fL 'J' tA �y-1 Nrrt fLf' �t r+ U P. r TJ K H �h • R� �! R f/ G U � vi o o a��� n r :,:,W��. � v m n o„ .. r rt, � � 4 7� ? O � O � 0 0 lli O O 0 0 0 0 0 O tA O � � r � J �1 .0 N 0 0 0 0 0 0 0 0 0 0 � c� n y r� x �+ N� 2 I? ►�. % b 'U 'cf �i �-3 H N W `� W .! y N N �� fG r r N 7% ih V � P� (n �7 Y F: j J � j J r. � rr n O r 1' : fD N ro �" ✓ � p "% � � 'D .., n r* F c� y 7? o o .��s n � .7 � W rr --I N 1 (� i ~ y �b � r � O � w� m U N <n �' n O O = o d C o m tn � r ,� J �.I N y 000o r.f 0 0 0 0 Vi iA N ih tA iA N tA �Vi Ll N V! �N iq i/l i!1 N N iA �N N iA N{/1 ilf Vl � O -� i,+ � o � ' r 0� C n � � � a N � m N � . 1'P ni 0 � N H N a � O � x ro H r�+ ro � �. �S � N 0 N a a .O � n � � � I a � M C � r x ro K � a �m 8 � � � � � N n � ro . pt H � o z x � � I a c rr � K n � Gry b\d O 9 � K � 1 0 L-�+ N C7 H z � � d C � t7 y H z � [�] � � y e O M � H z 0 J �j \ H C O � � ° o � � M d . � C H � 1 e z 0 � ro C H d H z � E z m � rn P+ �n H n Cf ,�,an � ~Kw y c r�n fD �o rt � Oi r w � tn rn � °'w°�m i Kc�r (�p N W N �P p. O - n roi, m w o��' N 1t F'• fD K C , ��aa � w d �r m °'• Y �1 � fD ai � K O "�C N N ff a � a J e K � rt ~ � a aM� ,a� � � � r. b �• � �• ; �am w r• w rr rr y N � w O • �a m � � �a a o w � n ei � o n a m � � � n a •c m r• m a £ `� 1 m r- ro � � a � ~ • �Y„ �m�� w �wco�o a�Y� �n�x � n a� � �o � r�n O tr a a K m N N y 'D 'o .r-. C7 � ---I CJ Z T O � � O � m � D '-o � D z c-� --i o c� z C7 D ►� Z --� a O S � D � � Z Cn G� � � N ---I C7 �t7 O 3 O N M D z 2 Gl d C� < m rn � � n tn D -a � 0 z �'1 m '77 � Gl m � a � 0 z D Z d n --1 -�G O '7"T T �:7 d r m -< II Iiili���w�� � � � 0 � � o� r� , - �~� sue�ecr E . City of Fridley _ 18258 � AT THE TOP OF THE TWINS g U I L D i N G P E R M I T r ; � CEIPT � • COMMUNITY DEVELOPMENT DIV. � ; L ------, �� � � � � � PROTECTIVE INSPECTION SEC. -`1 i � ----� /'�'1,� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE Of APPqOVED BY i ' � 612-571-3450 910-F15 10/22/85 / / 10B ADDRESS 7371 Jackson Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 1 Melody Manor 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Richard Maras 7371 Jacic�on Street N.E. 786-5860 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS 21P PHONE LICENSENO. 8 USE OF BUILDINa R�S1C3.eTlt1,8�. 7 CLASS OF WORK ❑ NEW � ADDITION � ALTERATION ❑ FiEPAIR ❑ MOVE � REMOVE % 8 DESCRIBE WORK Construct a 14" x 24' Addition to Back of Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS N,� � < <� �� �.:� ������aT� ���rwp�E�"� r ��,e.�t���� ��R �'�%������ �:���� �UBRI(V(�, 9��AT6B��, � �Cii����� ��� S���VS. Before digging call local utiiits�s TELEPHONE - ELECTRIC - GAS Etc. REQIII�ED �� L�`��`' SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S0. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. • NO. DWIG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED TMIS APPLICATION �. STALLS GARAGES AND KNOW THE SAME TO 8E TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $19, 450 $9. 73 WITH WHETHER SPECIFIED HEREIN OF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHAFiGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW FEGULATING CON- $]_�O. SO None STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECKfEE TOTALFEE 5.13 18 .36 SIGNATUREOFCONiR TOR AUTHOR12E AGENT �oaTEi WHEN ROPERL VA T IS YOUR PERMIT ° a� a (� e 9 IGNA REOfO N RiIFp N R IL I IDA EI BLO SP �1aTE ���.� � � � � � `� - _ �� - , E -� +�� . ' , �- _ _ - - _ �. � - .� � . - � , - - � - . ' � � 1�a1 � L- � � �9 /� - ��a D �� � •� i, 'f �ei,C�v � � � ld �� �1 � �' +��+�$�- , 1� �a � � �, �- � - �r- - _ �1 � .� �s� - _ _ �2��J� � f ��i�G- �s� �„ U�� � _ 3�.�� ' I �x� 1����6 � ��� i��,c� � � l�� - �� � : - � �Ve � �� � -� ��►���� �. - ,.�..' .; _ - .. _ � ��3 : ��, t� . �'�� � � ��`1� � ; NEW [ ] ADDN. [ ] pLTER. [ ] Construction Address: Legal Description: Owner Name & Address: Contractor: r v �� Address City of Fridley � R-1 A�iD R-2 i Building Permit Appliea � � 3 ����� � �,. �'�, � c ��" � Effective 4/1/84 n � l :� � � � 6 ��� Tel. � ' a �� - � � Tel. � Attach to this application, a Certificate of Survey of the lot, with the proposed construetion drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length ��t Width � Height ,� Sq. Ft. �_ GARAGE AREA: Length Width Height Sq. Ft. DECB AREA: Length Width Hgt/Ground Sq. Ft. OTHER: ��� x� �7 Corner Lot [ ] Inside Type of Constructi�fn: Approx. Completion Date: d �1�6 � �1? �� d. Setback Side Yard Setback �� Q (, �� Estimated Cost: $ �� C�� e�S� Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation . �. ���� � ` `� Tel. � � DATE: � APPLICANT: CITY QSE ONLY . Permit Fee Plan Check State Surcharge SAC Charge Park Fee SeWer Main Charge �� STIPULATIONS: � � d.�C1 $ �,� s �3 $ �.�� $ $ � $ ���•� Fee Schedule on Reverse Side 25� of Building Permit Fee $.50/$1,000 Valuation $425 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] - . . BIIII.DING PERl�IIT FEE SCHEDIILE 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 alte��tion,or repair to any existing building or struature, upon application ther;efore, require` the payment by the applicant for sueh permit of fees to the amount `h�r�iin,:'beloW s�t forth��and in the manner herein provided to-wit: Tot�3 Valuation Fees � - a1.00 to $500.00 �501.00 to $2�000.00 $10.00 (Min;imum Fee is $15.00') $10.00 for the first $500 plus $1.50 for each additional �100 or fraction thereof, to and including $2,000. �2�001.00 to $25�000.00 $32•50 for the first $2,000 plus $6.00 for eaeh additional $1,000 or fraction thereof, to and ineluding $25,000. $25,001.00 to $50�000.00 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000. $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.Q0 for each additional $1,000 or fraction thereof� to and including $100,000. $100,001.00 and up $�►33.00 for the first $100, 000 plus $2. 50 for each additional $1�0�0 or fraction thereof. DRIYEiiAY DEPRESSION ESCROii , (Conerete Curb Streets 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' approaeh With 6 inch depth - DriveWay �►idth plus 6 feetttimesd$15s7511 a 3 foot wide 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 onee it has been eonstructed will be required before proceeding with the framing. � .` .��► � �� �,� t .�:c.? P�'�� w;,,a�-�; � � � �� �4 . � �o'� � ;,, �' r� � G 1 �� _ 7'rk SSE'S Cv� • ' . � � F�o o r ..ti Ty k s5 E5 r�6 ,w�t� , . ,. �. ,B�t i � T %�� 7�i '1�` � Swts�t�. �oC �� �(2� � �� ,� ���y � �`� � �: s% � --- � � - . �� iVE•v c1���Ti�Or/ „ ...,r � �� � � V `� , , `,� j� �v .-�qo �u , , ,, � ��_. ._. �.�.. z'�'• LOWG� �' h��L� 'l w:,P , 3 a !� -- - - � �� . '' E � � , e � w � � ' ',� o � L- G/ 9 .. .. _• _ � -. . jonr Ilanniw� sfl�tl�lallil b+�s M��..�, �.esK�. � ` lond Swv�rin0 t • • (. Miew�op�li�� � • s,iy T.,,;,,� . � /tl�lllPP�lll�� •�ttC. ' M���. ssasa �i t�.+i t�...�� T.ie�. ���-eo�e '"�"k�°� ��Ns^� Engineere dc Surveyors ••N c°a. 6'� Mortsage Loan survey tor TRI-Cd Bl1lL��[�S c � � w- �c a � V , . 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Yes () No () The venting system is plastiGPVC and meets all cuRent codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the cuRent codes and manufacturers specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () No () The existina combustion air is sized and installet! to meet the current codes and manufacturer's specifications. Yes () No () When required to install a new combustion air. it wi0 be sized and instalfea -- --� -- To meet the cuRent codes and manufacturers specfications. Yes () No () When installina a new ventinq svstem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () No () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No () Apaliance Tvae and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Ass�stecf��_Na� �_ Appliance #2 Type BTU Input Fan Ass�t�tl:��i` 1�[ai,�' Appliance #3 Type BTU Input Fan As t�d�d��fi1��=� Total Appliances Total Btu Input � u; ���� «'} ��r��5 b �3 � r.. �� � �� . Common Vent Type Vent Height Diameter ����, inches Appliance #1 Vent o�cTo� Reigh� ----ft Lengih �I�iameter ' - in-Typ� - -- - - - -- Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length fi Diameter in Type ALTERATIONS: (Describe) HEATIN� C�: Signed By: Date : � O � � m m � � � c � s m tp � � � I � � o ° ,� I� N ,O IQ r � � r � N 0 N O � � a N � c�p D � o,Z� � � A N � � � � � 0 D � 'o N v � 2 � O a r � m � O Z � � � v � 1 Z ��`o v a � � � � 0 c � � � 7 v � m I � � � o � � � � fp 1 !` � M� � lJV � ) � � � � � � � � � o�i oni � � � � -1 A fA N � � �i � 7 � � a � � o � � � � � � z o o� � O A 7 m A����� w c� �. � s � � � �m � � y �' S �U W � e� A; i. r� � N!C N � 1 I � � n`�i � c�o z � � m � �° A �o ,+ y fp � —1 � F � y � � � � � i = �' A � C c �° � � A� _ �. � � N � �� ( I I I I I I I I I I ► v► w�r►��►tsra�a�e��►ws�s U� O O O V p V V V V tA A V 0 ooSoagn000ao � r c � � Z � � � � D 2 � m 3 0�. � a n 0 N .�. s 0 � m � � � Z O � � �O c N (D a D N O w � � � a � � '� � � 1 N � r = � ?; o' 7 y � � c�o � a � ' z"s N � : '0 , "O ; O ' m M Q I � i � i ..� 4 � I /1 "' i i/ ' C i m; �- a ; A � Q 1 �.� � � �° � I � i � I ° �P � i y _ � m ; 3 c y � 7 a o. � m y � � : � ; � a � � S O � `, a • o � p1 3 � o m , � �n �. �1 7 � � � � n ' C� �. ' w o A 7 � O O , m w , � (��D �. � c. �, � o � � n � � O O � � � N � 7� v C � m 2 c,i � iC � m � � z O � m o. � L O o� D � v � � � 0 � � �� r N � Of n N a w � O�f '� � � A � �� � z � � (n N A � r W D '� N � � Z Z m � n � O z � < C � o � �'� � � G � � (D i� m O 7 L W � C m � � J J � f0 t0 • � Building �/j����j���j., Permit No.:Zc��(� ��3- Inspections �i S��i �"�'�� ���j(;�'�'���j Received By: l7� 763=572-3604 ��•� �� ��� Date Rec'd: S C� 763-502-4977 FAX EFFECTIVE2-19-09 DATE 3- � I- I V YOUR E-MAIL ADDRESS SITE ADDRESS � ��` W � 0 Cl-l� LO— F� I AI c, � THIS APPLICANT IS: ❑ OWNER �ONTRACTOR PROPERTY N�: �Jm�,� � � „, ,J OWNER/ N1-` CITY ��e.i �l `, sTn� � zrn bJ� 3Z ADDRESS: (a b�b Li 1� C4 Cl �, �-�' TENANT PHONE: '7 6 3- �-{ � oZ — cl 7�1 �- —� CONTRACTOR COMPANY NAME: .. L�� �` ��� � 1� �'� a- � SUBMTI' A COPY OF CONTACT PERSON: C I,� ,� �� � YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS:�dg o V-� o-1�.., oS$ N L CITY F�R,i �1 STATEH►-� ZIPSS`�3�. APPLICATION pHONE �% 63 �S `f J� �i R FAX PERMIT TYPE �rYrE oF woRx: �INGLE FAMILY ❑ TWO FANIILY ❑ NEW il� REPLACEMENT ❑ TOWNHOUSE ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK �ro5��a ( I �,0 � �+-�'�'l. �r►t Ae2- �b''v� ` � �O^"'° FEES ARE BASED ON $10.� PER FIXTURE, EXCEPT R�RE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOR� Equipment Installed MFG: 12 v V t0 MODEL: I/.A f' c1 � 3.i� SIZF./B� , ; ����- MFG: MODEL: SIZE/BTU MFG: MODEL: SIZFJBTU J A/C $25.00 FIREPLACE (GAS) $I5.00 GAS RANGE/OVEN $]0.00 AIIt TO AIIt EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOII.ER $35.00 FURNACE $35.00 _GAS LJNIT HTR $10.00 _CHIMNEY LINER $10.00 GAS DRYER $] 0.00 POOL HEATIIi $35.00 DUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR $15.00 THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building pernvt 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 and with the Minnesota Construction Codes; that I understand this is not a permit but only an application 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 of all work which requires review and approval of plans. � SIGNATURE OF APPLICANT C(t/Lt O PRINT NAME �� r�J �,O iQ DATE 7w o�:- �( b City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building Inspections 763-572-3604 763-502-.4977 srrE nnnt�ss_ THIS APPLICANT IS: PROPERTY OWNER/ TENANT PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY F� �cTTVE i-�-ao�o CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF 1NSURANCE PERNIIT TYPE TYPE OF WORK: DET YOU�R `E�MAIL � [x� � � i x��— STATE LICENSE # STATE BOND # ADDRESS: CITY_ PHONE FAX ❑ SINGLE FAMILY 0 NEW [ohv.oF wo�uc V�t ❑ TWO FAMILY ❑ TOWNHOUSE �� G� PermitNo.�i�� L�S Received By:_� Date Rec'd: — J ' � EXP DATE EXP DATE C� ATE '�": 7'E ZIP FEES ARE BASED ON $10.00 PER FIXNRE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. BATH SINK/LAV FLOOR DRAINS SHOWER _ WATER PIPING — gp�Jg GAS PIPING (NEED CITY LIC) SWIMMING POOL _ WATER SOFTNER ($35) CLOTEIES WASHER KTfCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15) DISHWASHER LAUNDR'Y TRAY WATER HEATER ($35) FOR IRRIGATION — — WATER METER _ OTHER THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 and with the Minnesota Construction Codes; that I understand this is not a permit but only 'cation for a p rmit and work is not to start without a permit on site; that the work will be in accordance with the approved an in the c oi�ll wo w�Rjch e uii� view prov o plans. 1„ l SIGNATURE OF APPLICANT ��'^- " ` �E � � ��. � ��ATE 1 � City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 ' FAX: 763-502-4977 �a � oG Building Inspections 763-572-3604 763-502-4977 FAX DATE % �Z � f �O SITE ADDRESS� % � THIS APPLICANT IS: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-1-2010 YOUR E-MAII. ❑ OWNIIi BC�NTRACTOR Permit No.: D���, � PROPERTY OWNER/ I NAME: �t c� e /�I ---� TENANT .�.nv�ss: 7 3?/ TA r/C S oN ST �v .�crt�t ir .�/ L�w sT �� CON1'RACTOR 1vpME:1_c,rCLC .�v 9� T��v GL/d C�6�! '�' � SUBMIT A COPY OF STATE LICENSE # EXP DATE YOUR STATE LICENSE AND CERTIFTCATE OF ADDRESS�9 � 9 S/� RO� CITY � ST ZIP,�y� INSURANCE pHQDiE q �Z �i''�.� � � � FAX PROPERTY TYPE PERMIT TYPE � SINGLE FAMILY/NEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION 0 BASEMENT FINISH ❑ ROOF ❑ DECK ❑ SIDING TYPE OF WORK: ❑ NEW HOME CO1dSTRUCTION ❑�D DTfION ❑ MAINTENANCFJREPATR ++�1ZEMODELING DESCRIBE WORK BEING DOIV�� 1 .j ^ SIZE OF IMPROVEMINT LINGTH WIDTH ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE 8c GARAGE GARAGES ❑ ATTACHID GARAGE PROPOSED SIZE: ❑ DETACHED GARAGE PROFOSID HEIGHT: - _ ❑ DRAIN TILE ❑ OTHIIt � HEIGHT FT HASEMENT REMODEL,ING SUBMIT: 1. Existing Fl�r Plan 2. Proposed floor plan -- 3. I.ist nf strucdual members Yo be ysed SIDING FOR NEW CONSTRUCTiOld INCLUDING DECKS, ❑ Vinyl OSoffit .ADDITiONS. & PORCHES SUBMIT: ❑ Alumimmm ❑ Trim 1. Site PlanlSurvey showing the e�cisting strucUues ❑ Other ❑ Fascia 2. Two sets of co��nstruction ptans R'INDOWS 3. Energy Calculations IN EXISTING OPININGS Yes ONo LOCAITON OF WINDOWS FOR WINDOWS — PROVIDE U-VALUE AND OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE STTCKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALL ���/ NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE CO5T OF LABOR AND MA7'F.RiAi �; �SING THE 1997 U.B.0 FEE SCHEDULE) 'OTAL JOB VALUATION $ A�od OCCUPANCY TYPE Permit Fee Plan Review Fire Surchazge Surcharge License Swchazge SAC Charge Curb Cut Escrow Erosion Control Pazk Fee Sewer Main Charge °� �� a�:�� See Back Page for Fee 5ch�ule $ 65% of Building Permit Fee � 1 .001 times the total job valuation $ "'') .� .0005 x Pernut Valuation Minimum $.50 $ . L �' $SAO (State Licensed Residential Contractors) $ $2100 per SAC Unit (Plans to MWCC for determination) $ ii+6ft= ftx$22=$ � $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $_ �� D- k�> Make checks osvable to: Citv of Fridlev � Att.n THIS I5 AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclmowledge 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 and with the Minnesota Construction Codes; that I understa,nd this is not a permit but only an application for a rmit and wor " to start without a permit on site; that the work will be in accordance with the approved plan in the case of a11 wor hich req ' re ' and approval of plans. a SIGNATURE OF APPLIC PRINT NAME SGO T% �B/ I✓ Dp� %�Z /�D PL�ASE NOTE: SEPARATE PERMITS ARE REQUIItED FOR ELUMBING, ELECTRICAL`�,NI� T�C�-I�NdCE�i.`�/OIZK