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AF - 47501City of Fridley, inn BUILDING PERMIT .;, N° 5560 � Da�: —.�� -�-,� �`�. '�t � � <�'� ' +t owaer: � -, _j � a,,� � :.;�__t".�.�� swuaQr ' _ �' Address Address — ��,,/ ��g � ,,�oCAT10N O� �1� �D ,NG No. ��4�! street ' � ,� � �.��,`�� "..��`-��°� Part . � r Lot _—_.�.____ Bl — Addition or Sub�,,Di on f Corner Lot _� Inside Lot l�tback ��`°' Sideyard Sewer IIevation ____� ' Fo dation IIevation DESCRIPTION OF BUILDING � T � ?��'� ,/�-� , ,r, s9.�,�� >. '� �%° , Front .�� Depth �� Height � S4• �. ;�� C�. Ft��^"' �'' Depth Height y, .�.. S�i• � � F''� � �� .� Fost. cost �;�;�=.� T.�= � ��,W Type of Constcuction��+""`��` ��=�� To be Completed , , a . In consideration oP the fssuance to me of a permit to construct the building descrlbed above, I agree to do the pro�sed work in accordance with the descripf3on above set forth and in compliance with all provisions of ordinances of the dtY of Fridley. ��r �: � In cone�tderabion of the paYment oP a fee of $�"""'"'� , P�t is hereby granted to to construct the' bwtlding or ade7ition as described' above. This permit fs granted uPon the elcpress condition that the person to whom,it is° granted and his agents, emPioyees and workmen, in all work done in, arotuid and upon, eaid building, or any part thereof, shall conform in all respeets to the ordinancea of k'ridley, Minnesota regardu►g location, construction, alteration, maintenance, repair and moving oP buil v�ithin the city ]imits and this permit may be revoked at any time upon viola of any oE the P�� oE d ordinances. �� JJJ�� h � ,,�',�/" ',�! . s r, �' f� Buildin8 IIIBpeCtor , �� _ —?�• r, �'r_«F='�.�-�� NOTIC� This psrmit do� aof eover �he eoeatruetion, InstaUalloe ter wirin8, plumbtog, eas heaHng, sewe� o� water. Be wn to �e fhs Buildin0 Inspeetar Po► sepanie permits for tM» ttsms. , .�.. S- ;:-�' �4 >^'`� +R' '_ � }'� f.'i► Owner's Address APPLICATIOi�1 P'OR BUI�DING PERMIT c��r og r�i�r�Y, �12�sarr� LOCATIOI�T OF' SUI�DTNG No. �f- Street� -�-� 7, o� Lot,_,�,_ ° � Lot; �, Block Addition or Suhdivisio Corner Lot inside Lot Setback__,Sicle-Yard SEV�E�t ELEVATION L'OUNDATION �LEVAT208T Applicant attach to this rorza Certiiicate of Survey oiE Lot and propoeea building loca�3on. i o �,� ,�s.ed- as o DESCRIPTTOLt1 OF HUILi�?l1TG Front��Dopth � � Y3e3.ght / � S� e Ft . - - � �� Cu . Ft . ��D CJ .�"..� �— FrontiDep•�h �ieight Sq. Ft. Cue Ft. � Type of �onstruction�� Estimated Cost � � To.be Completed The unders�.gned hereIoy makes appli�ation �or a perm3.t tor the wo�k herei� specified, agree�.ng to dv all work in strict accordance with the City of Fridloy Ordinance8 and rul�.ng o� the Departmeat of Huild- ings, and hereby dec�.ar�e that all the faets and arepreaen�cat�ons sicated in this applicatioa are true and corroct. /� ��'�'� SIC,R�TA3' �.� �.�__.. ,� -Tr-n..ti (schedule of Fee Costs can be round on the Rever �ide). �''� �- u � � . . _ @• BUILD�NG PE1tMIT FFE �GR3EDULE � a Sec�io� 2. The T�spectog of Buildi.n�s shall, before issuing any perm3i:. for the e�ec�ion o:� any 1ou3.lding or stxucture, or for any add�.�tion to any oxis��g �uilding or s�cuc�ure, or for any aitorat�.ons or repairs �o any exisic�ng building or strucicu�e, upon applica�lon �he�-e�or, require ic3ne paymen�t by �he a�plican� for such perrait of fees �o �the amount herein belaw set forth and in the manner herein p�ov�.dec1 to-wi�to 2.1 a For any such pe�rnit �or the erection o�E any fire-p�oox` building, o�her �than a garag�, waYel�ouse, facto�y or grain elevator, or �or 'che erec�lon ot any �ire-p�oof acidition, for similar occupancy� to any exis�ing buildi.ng s�a11 b� at the ra�te of $1.40 for each on� thousand cu'�i.c �eet, or �rac�tion t3�e,ceaf, i�n such cubical conten�s e 2.2. �'or any such perm�� or �che er�c�3on of any �'ire-pacoof garage, warehouse, �ac�to�cy or gra�n eleva�tor, or �ar the erection or any �ire� proof addi�tion, �ox similaTC occupancy, �o any �xistiag building shall �e at the ra�te of $�.25 for each one thousand cubic feet, classi�ied as "�isep�cooi" by �ection 502 0� the Minneapolis Building Code. fIOUSE S 2.3. For any such perm�..� for t�ie erection oi any non-fireproof bu31d- �.ng o�her than a garac�e, v�arehouse, fac�ory or grain elevator, or any non�firep�oo� addi�ion, �or s3milar occupancy, to any exis��.ng build3ngo Perzni� $1000 for each on� thousand cubic feet. G1'�AGES 2eQ. �or any auch peTCmit for �he erec�io� o� any non-fir�proof gaxage, �varehouse, �actogy or gra�n eZeva�o�c, or for the erection of any no��irepgoo� addition, �or similalc occupancy, to any existing build�.ng or �or each such bu.ilding or additione Ninety Cen�ts for each one �7nousand cubic �ee�t or fraction tchereo�, in the cubical contents �thereof wi�h a min�n�n or $�,00 e �'or �he pu�pose or computing fees for building pexm�.ts the cubical con- ten�s o� any bu3.l�ing t�r add�.tion �to a uniform height throughout by mult�.plying the g�cound area covered .�xom a poj.nt aix (6) iraches belaw �he rloor line or iche basement or cella:r �o the average height o� the upper sur�ace or �o 'che average heigh� of the roof surface of the znain gable of a pitche� rooi. 2e5. For repa�rs or a1.te�at3.ons to an shall be at �he ra�e o£ $3.00 per each or �xaction �hereor �n �he cos� o� all exis�ing structure, the �ee Five Hunc3red Doll�s ($500.00) pro,�osed vuork e 2.6e 3n no case shall the ree charged for any permit as s�� forth in y �ecQ�ion 2 be less �� $4.00. ^ y � .r � � '� ; — _s e..?� s � "'�"j�� ' 1'' � .v -�' � ' � � � ��?� o� a` / � ui+ Nan� �-`:�-d��-^�� /`,"_ x / �-`-'�°`°� `a°�� fiT7F �" � •..�.►.r..�..,. B�.00Br______ AUDRESS � � � � � �'�: F.��.. � � ��' � p 9ALII.�TIa19' �� AD�, ��...�'�-�.. ,�... TYPE ��.�� a,,,.,,_ .,._.... _.. � � �,� � � �,, � � � � ;`; , �, � ; �,_ J � � � � \ i � � h � �� . .�, �(� �� V 'il � �; �� i �� '1 � , ,-r ? � �r � � �� . � �� 1 _v � � �!, �� "�, F �r !j � � V C �``' � � � � � � � � ��1 � O a 9 O � � � "N! � Y V t� ;oQO aJ � `� �� s� � � � i e K o � �... Q�, �'.�i `' '�A �`,� a � �V °' a x `� V � �� a. '� m a L � '�`i � � � — r : = o � � o � m d d t X �j m � � � � � I .�_.e_ �`' .. - G,. d Y G L � -!`C � t a m io '� '" �..- u � �m c � � ;'-.. F°.°.m (" "'� « Y m n C ` i, °'E90 �y � �'� �o«Ym � � � nr � j �°a m m� m !/ � " ` I � ,�� 01 v — /� 1 �« c o it � G+ � �"'�� l��`'�' Q � .� o C c i '�. E p� `�.s' ��` r\ (� q�"+'�. �.� '� v� C'�a, i 1 �` �/ `� w w � '', �l �� -�. � � '�s � o 9;.+ i r� 2.;; ' � ° __ � �� `_^� X� O !� + 1,r N I I i � FRONT...._PROPERTY ...L�...�.. . � �� F� � � \ E� � v � �, Yt � � � � �.: �� .� .. � ,rY/ � r.� . !t� 1� \�' �r . �� r`'�` . \ �� r� � - City of Fridley, Minn. N° 9 2 0� BUILDING PERMIT � '� �� /e� � Date: April 26, 1967 �er: ! Eran.k Barnard B��r Moen Mfg . Ad�eas 6301 Jefferson St. N. E. ____ Addre9s 4733 Chowen Ave. So. LOCATION OF BUILDING No. 6301 S�t Jefferson St. � „__ p� of Lot � �� 11 �__ gl� 5 __..._. Addition or Sub-Divisian .�Christie Corner Lot — ____ Ins�tde Lot — Setback _.._�_ Sideyard _ Sewer IIevat3on —� � Founda.tion Elevation DESCRIPTION OF BUILDING To be Used as: In.stall prefabrica�t � Depth Height — Sq. F't. Cu. Ft. C imn.ey ---_--- Front Depth ._.._. I�eight _._..�_.._. Sq. F� � G�1. Fk $105.00 5/1/67 7�oe of Construction _._.. Fst Cost — ....—___.�..._..__ To be Completed in consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description abo set forth and in compliance wlth all provlaions of qrdinances of the dty oP Fridley. In consYderation oE the payment of a fee oP $ 5. 00 ��t is hereby gran.ted to Moea Mfg . to construct the building or addition as described above. This permit is granted upon the express condition that the persfln to whom it is granted and his agenta, employees and workmen, fn all work done in, around and u�n said building, or any part thereof, slzall conform in all respects to the or8inaacea of Fridley, M9nnesota regarding location, coastruction, alteration, maintenance, repair and movin8 of bufl within the dty lim�its and this perrmit may be revoked at any time u�n violation of aay of the proviaions of d ordinaac�a. CLARENCE BELISLE Builain8 inspector NOTICE: 'Ihis pse�oH das eot eowr fhs eons�nreHoe, huhllallon fer vrtrtee, plumbine, �as heaHng, ssvra er watsr. B� sun fo a� Nro Buildieg lespasta� for uparab parmNa for f6as If�eu. � ^° L �� ,a 1. �'•. __ ;� ,�� /' ��; �,.* �� '�. � ,� r_�f� p'�� q� � �• .�� APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME �� /�' C � �' / �'1 � �� UILDER ` � � � � �- ` � � annxESS �3� / .S� �� '��5� '� �-�c ADDRESS �i? 33 C /-�c,� c � �(��-�-� . � t LOCATION OF BUILDING N0. � �t� / STREET �c ;f � � � d _� -� -- PART OF LOT LOT- - J � BLOCK __ �a - _ ADDITION OR SUBDIVISION Ly�7-'� e �-� � � (�* - � Q ��•-;. �_� CORNER LOT INSIDE LOT SEWER ELEVATION SETBACK SIDE-YARD TOP OF FOOTING Applicant attach to this form two certificates of survey of lot and proposed building location drawn on these two certificates. To be Used as: DESCIPTION OF BUILDING Front Depth • Height Sq. Ft . Cu. Ft . Front Depth Height, S Ft `r �� Cu. � O � �-cJ Type of Construction Estimated Cost To Be Completed- �° `��1 � � � � The undersigned hereby ma.kes application for a permit for the work herein specifi d, agreeing to do all work in strict accordance with the City of Fridley Qrdinances and ruling of the Department ot Buildings, and hereby declares that all the fa s and representations stated in this application are true and correct. DATE SIGNATURE ,-- �(Schedule of Fee Costs can be found on the Reverse Si , �� -``-� � ��,/� c :��t`�,�,4-� ' . ��c.�c'`I � �y►�i � �,sJ �� , • `�- �. ; - � � . ��s ��- , � �� C�'�' BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building of structure, or for any addition to any existing building;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: Ur..iform Building Code: Type 1,2, & 4- $1.75 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3& 5-$1.50 for each one thousand cubic feet. � For the purpose of computing fees ��or building permits, the cubical contents of any building or addition to a uniform height throughout by multipluing the ground area covered from a point six (6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height of the roof surface of the main gablc of a pitched roof. For repairs or alterations to an 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. In no case shall the fee charged for any permit as set forth in Section 2 be less than $5.00. NSSSD Connection Charges based ou location- Area 1 or 2. � G�a -A"n a° `_ � ; �� 0 � 0 ..-�a _� � , ,\ � � �"1 Cit� of Fridley, Minn. �UII.DING PERMIT Date: dv�.e l, 1965 �� No '7623 p�; k�ank Branrt8rd g„�d� �nster Construet3er� �� . Adare�� 6310 J�ffersoa SSt. N. E. Aa� 63L�2 �3sard ��e. �'o. LOCATION OF BUILDING No 6 10 g�t Jefferson Strest �T. E. part of Lot Lot � _ Block 5 Addition or 5nb-Divisian ��i@ gddition Coraer Lot _ In�ide Lot —. Setback Sideyard �W� g�� Fo�mdation IIeval3on To be vsed as: Front Front Type oP Conetructton DESCRIPTIOW OF BUILDING Depth Height Sq. F't. Depth Height Sq. F't _-._. Est. Cost ��yl}QQ.O�__ To be Completed Cu. F't Cu. F't Storm Dama�e Repair In consideratton of the issuance to me of a perm�it to construct the building descrit�d above I agree to do the P�P� work fn accordance with the description above set rFh and ffi I�tanice with a�l proviafons of ordinanoes oP the dLy of FrYdley. � In camsfderation oP t�e payment oP e fee of ��, permit is hereby granted to�?'?'�d D. Rrn aah eT to construct the building or addit%n as d�cribed above. This Qe�mit��g �� u�� the express c;onditian that the peraon to whom it is granted aad h9s agents, employees and wor done fq around and upon safd building, or anyp� thereof, shall �nform ia all respects to the ordir►ance� of FridleY. Minnesota regar8lng lacat3on, construct�on, alteration, maintenance, s�epair aad mov3ng of bufldi�gs w1o�� dty ]im�its and thia permft may be r+evoked at a�q time upan violation of any af the P�vl�iiona of safd i�l].eYl den30A B��S �� NOTIC� 71ds perml� doa ee! eeva f6s eomtraaHon, �oo iar �rlrta9. P��B. 6a 6Wing, sewa or wNer. B� sors to a� � Buildin8 t�or ior pparal� �nrmtts Por fha� �. _ � _ .. � __- � � , � . AP'PtiiCATYON � RO�t "BUZLD� PERINIT . - � . . .. : , . , :.' � �ITY' OF 'FiRIDLEY,� MII�IQESOTA ' - QWNEB � $ N� �� G . ��.��s��_, � ;,,_�.,,,,. 'BUYLbL�Tt•.�1�L�G:�. �� - �., li� . � ...._�, �___ �A , ... �DDRES$ If .� � �� _� �F'�e �r � � , ADDRESS ±��j �i . �%/�r �i�.�%� �a. . . . . v ��. ,� � . . � . • � . .. � . : . LOCAZ"tQl� 'OF BUILDING � - - , . p-, . .,. :. .,. - - No. �� , . , ,: � , . �Lyreet � .. � . ____��_. �_;P rt' of Lot' � � �� LOT � BLOCK � � �4DDIZ''tON OR St18DIVISIOR �� ' A;o'�,;� Q�s!' �, �C ��- , _• Co�ne� �,o�� nsid� L�T. ` Setb'�'ck . ' _ �ide�Yard . : . •, �!--r+�..� . . . �----r*�►� . : , . _ t� : , : . .. � _ � 3EWBR' EL��VATYON . . ' ��t�A�TdN ELEVAT��N� ' : : ;' . . . , ., � , � . . .� . . , . . . . - . - Ir7rrr� '�r�� Applicaat attach to thi� form Two CarCificaCea of Survey•of Lot and proposed building location drawn on theee Carti£icates. . .-._ . � �' DESCRIPTI01� OF BUII,DiNG�``� ,, � .. To be ue ed : es : � • . . . _ • �Fraat � Dept `�` eight� 3q. Ft. Cu. FC. .. . ,-. , �..� . , , . � . . :' .. . , � FY.ant ' `D�pt. �TwH��ight ' _ .. , ' . _ : • . S'q.' �'t.` . . . � Cu. FC: � ._ Tqpe of Coitetruction Estimate�c� CoeC �� c� , , . . ,:.. . , ...,._,�.._�... ...._ To `be co�pleted . ,,. _ . , . _ � . . � . � . • � � . - . ! , •�" ° . �'�'�,,..r....�._� � ! . '�' ' . , �r.. . - � , . . . , _ The underaiga+ad hereby makes� appYicat'ion for a peitiuit for thb work bereia epecifiad, agreeing to do'a].1 work in sCr3ct accordaace with the City,.of Fridleq„Ordinances `'aad rulings�of'the Department: of Bu�'ldi�gg; and hereby declaxes thaC_�i.l the facte '�'and .repaesentations �tated ia 'this applicat'ioa a�e' true and c-orr�ct.. � � •� � �� _ ,.. � � DATE �%,�� '' � �� SIGNATi?ItE - (Schedule of Fee Coets can be found oa the Reverse Side).. �� . _ + r.. . ..� « ��1 � �G "'. ^-,:� •-BOILDING.PERI�T FEE SCHEDULE SEG°P_ ION 2. The :Inspector of Builc3inga shall, before isauing any pes�milt for the erection of any building or atructure, or for anq additian to any esisting build- ing or structure, or for anq alterations oz repairs to anq existiag building or stzucture, upon application therefore, require the payment by �ha;.applicant for � su�h permit of fees to Che �mount herein b81`ow set foreh and in the manner herein provided to-wit; � 2.1. For any auch �ermit fb�t the erection of an�y fire-proof building, other than a garage, watehoiise, factory or grain elevator, or for the erection of any fire=proof addition, for similar�occupancy, to any existing building, ehall be, at t�ie rate of $1.40 foa each oae thousand cubic feet, or �raction �� ° thereof, in such c�tbical contents. � �2.2. For anq auch permit for the erectian of any fire-proof garage, Warehou�e, factory or grain elevator, or foz the erection of any fire-proof °� addition, for similer occupancq, ta any existing building shall be at Che rate of $1.25 for each one Chous�nd cubic feet, class3fied as "fireproof" by •-� Section 502 0� the Mianeapolis Building Code. flOIISES 2.3. For any such �ermit for t�e erection of anq non•fireproof building, other than a garage, warehouse, factory or grain elevator, or any non-fireproof additioa, for aimilar occupaacy, to any ex3.et3ag building - permiz $1,OU for each one thousand cubic fest. GARAGES - . �_ --2 4. � For anq auch permit for the erection off any nan-fireproof garage, warehouse, factorq or grain elevator, or £or the erection of any aon-fireproof acidiCion, for s3milar occupancq, to any existi�g building or for each euch building or addition - niaety cents ($0.90) for each one thousand cubic feet ar fraction thereof, in tHe-cubical contents thereof `aith the minimum of $4.00. F�r the purpose of camput3ng�fees for building permits, the cubical contenCs of any building or addiCion to a uniform height throughout bq multigly3ng the � ground ares covered from a point aix (6) inches below the floor line of the basement or cellar to Che average height of the upper surface or to the average height of the roof;surface of the main gable of a pitched roaf. t �.5. � For.repaira or alterativas to an existing structure, the fee shall be at the rate,of $3.00 per each Five Hundred Dollars ($500.00) or fraction thereof in the coat of all propoeed work. 2.6. . In no case ahnll the fee charged for any permiC as aet forth in � Section 2 -be less 'than $4:00.�° � �. � ��_ � �� fl � � , .,�.. � �� ' `� ��e-� �2� '/� d�� !!��-�2, ��- ...C��.�c�s��'�-� � � � �� i� .��-�� . . �� g � � ��. �� ,� / ; � � i � � - � ; i� y . / l � lf / r- I� � �� IL�� ` I/� ,�� - �o_ � � �� _ SuBJECT City of Fridley � � � ��9 �� AT THE TOP OF THE TWINS g U I L D I N G P E R M I f ' � �i y___._ COMMUNITY DEVELOPMENT DIV. � T NO. r � � PROTECTIVE INSPECTION SEC. .'�/� � . � b[ � ' �"'1 � CITY HALL FRIDLE� 55432 NUMBER REV DATE PnGE OF nPPROVED Br �'""'�" ��' 612-571-3450 910-Ft5 6/20/9 � � 10B ADDRESS 6301 Jefferson Street NE 1 IEGAL LOT NO. BLOCK THACT OF ADDITION SEE ATTACHED oescR. 11 5 Christie Addition SHEET 2 PROPERTY OWNER MAII AODRESS 21P PHONE James Yerigan 6301 Jefferson Street NE 574-1625 3 CONTRACTOf; MAIL ADDRESS Z�P PHONE LICENSE NO Same 4 ARCHITECTORDESIGNER MAILADDHESS ZIP PHONE LICENSENO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION O ALTERATION � REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (17�Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTI�ATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. 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. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GAFAGES AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIED � 1�/�OL �.%O WITH WHETHER SPECIFIED NEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- �(}H.SO Fire SC �1.40 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECKFEE TOTALPEE $50.60 S NATU�7E OF CON'RA TOA OR AUTH0�71ZED AGENT IDATEI WHEN PqOPER VALI TED THIS IS YOUR PERMIT � �� > , ` - � Si ATUREOFpWN WNEABUIL IDATEI BLD �NSP qaTE NEW ADDN ALTER [l [l [l CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: � Legal Description:� E, JL /, � '�t o� �r �, i S'�j.° ,� � Effective 1 / 1 /97 �313� Owner Natne & Address:�prr-�� g��/2i� Tel. #� 74G-/��_ � Contractor: c,��,L/� MN LICENSE� Address: �' Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTI�R: Construction Type: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlVIPROVEMENT �n� Width Height �n� . Width Height �n� Width Hgt/Ground _ Driveway Curb Cut Width N�ded: Sq. Ft. Sq. Ft. Sq. Ft. �K D��. � - � Fstimated Cost: `��% O P � ��Oa �' (Fee Schedule on Back) Ft. + 6 Ft = Ft x$- —$ DATE: �'ol� APPI.ICANT• � Tel. # � c 7'� ��' Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ o.�� $ , �{� �_ � D $ $ $ $ $ $ � ��- �� CITY USE QNLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $950 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 [ ] IiUII,D[Nt� I'ERM(T EEE SCHEDC�Lt: "1'lic Chief Building Official sl;all, b�fore issuing permits for ihe erection of any buildrng or structure, or f-or any addition to any existing building or structure, or for any alieration or repair to any existing building or structure, upon application therefore, require the�paynnent by the applicant for such permrtof fees to the amount hzrein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $S00 $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 $1,000,000 $1, 000, 001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $1(}a or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fractiom thereof, to and including $25,000 $349.75 for first $25,�0 plus $9.(� for each additional $1,0(}0 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 $1Q0,000 $887.25 for first $100,Q00 plus $5.00 for each additional $1,OOO�or fraction thereof, _to and inciuding $5(�,000 $2887.�5 for the first $500,{b0 plus $4:25 for each additional $1,OQ0 or fraction thereof, to and including $1,OOO,p00 $5412.25 for the first $1,OOU,000 plus $2.75 for each additional $1,OQ0 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. ` Iternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet ti�nes $15.75. VERIFICATION OF FOUI\TDATIOti' 'crmits for construction will be issued a minimum of 24 hours from the time of application to allow for�proper ��.:view of the proposed structure and of the construction site_ 'y Certit icate of Survey of the lot, � showing the (ocation of the foundati�n � mce it has it has been c�nstruc' _•.: �::1 t,� reyuired t��t<�rc ��ri,cc;cdin�� vith the framin<*.