AF - 47691Date �?'������:.........
Owner . � . .� . .����
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Address . . � � . �,�. . `�, ;
BUILDING PERMIT
Village of Fri�.ley, Minn.
�� ... .......
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N° 2213
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Builder . . . . � :-�:� �`'�.�:�'':� . . . . . . . . . . . . . . . . . . . . . . . .
Address.........................................
=r�� '� ;LOCATION OF' B ILDING
No. . .��. ��.�. . . . . Street . `'� ,s������-�:`�: �'` :�'ii���. �: . . . . .
Part of Lot . .... ..
s � ��. .
Lot ......�+!�..... Block . .:►�d.'....... Addition or Sub-Division ..,_•'-�,�'�lf "l;&�:�.�'�°.. �� .......
'�, .... .......
Corner Lot . .... ... . . . . Inside Lot . .. . . .. .. . . . Setback . .+4���.�.+�`� Sideyard �l�.�. e���. . .. . . .. . . . .
DES�CRIPT[ON OF BUILDING
To be Used as:
',���� '���+��.�. . . Front . . �.� . Depth . .'.�;�!. . HeigIit .� :�'�, . S Ft. .
' 9• ....... Cu. Ft, ........
d.'��:�:!��. . . . . . . Front . ,�..'t°'�r. . . Depth . r�:�!' . HeigIit . . . . . . . . . S F`t. . . . . . . . . . . . . . . . .
9• Cu. F't,
Type of Construction . ��.,:� t'�:t ��{". Es� Cost . .��eP�'� . ":�: . . . . . . . . . . . . . . . . . . . . . . . . . .
To be Completed
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
tt►e proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
�.� ............................... .
In consideration of the payment of a fee of $..��:""';', permit is hereby granted to ....,� .. ..: -�
.. to construct the building or addition as described above. This permit is granted upon
Y,he.express condition that the person to whom it is granted and his agents, employees and worlanen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to� the ordinances of
�'ridley, Minnesota regarding location, construction, alteration; mainiena�nce, repair and moving of buildings with-
in the village limits and this permit ma.y be revoked at any L-ime upon rriolation �,�f, any bf the provisions of sa.id
orc3it►ances. r�" ;�."
• . ,. �' _ _ i': 4, ` .
���,�`� •,�;��`�"�'�ilding Inspector
�_
NOTICE: ~
This permit does not cover ihe construction, installation or alteration for wiring, plumbing, gas heattng,
sewer or water. Be sure to see the Bullding Inspector for separate permtts for these items.
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SUBJECT PERMI �
City of Fridley . 150�9
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
� � ECEIP
' � �: -----
COMMUNITY DEVELOPMENT DIV.
r � PROTECTIVE INSPECTION SEC. � s� ��/�
1 �.1 i � ��
�� 1 /�"1 � CITY HAIL FRIDLEV SS432 NUMBER REV. DATE PAGE OF APPROVED BV
•"'� ♦ ,�� 812-580-3450
910-F15 11/20/78 � �
JOB ADDRESS 6371 Jeffer�.on Street NaE.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ZS 5 Christie Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Richard TirT�od 6371 Jefferson Street N.E.
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
C& M auilders 4536 Jefferson Street N.E., Mpl.s. Mn 56a-7714
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
ReS 1C�2ri't].� �.
7 CLASS OF WORK
❑ NEW C� ADDITION ❑ ALTERATION O REPAIR ❑ MOVE � REMOVE
8 DESCRIBE WORK
Qonstruct a 1C' x 24' Addition to House
9 CHANGE QF USE FROM TO
STIPULATIONS
• � — �ef ���N��� . .
ScPE�ATE �'��'�iT� ��Q�JI�tED FC�R Y11lRi�C�, ore dig�in� call lacv�i u:`,;.��cs
F�E�T91�G, P�.UN��1NC Ai��p S9�l�JS. TELEP�PO!�E-EtEC7P,dC-Gr"►:; i=�„
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SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. �1jOOCI F',xaIIL@
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION.
OR WORK IS SUSPENDED OH ABANDONED FOR A PERIOD OF 120 DAYS AT 384 4�OS
ANY TIME AFTER WOFiK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GARAGES
AND KNOW TFIE 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 GRANTING OF A PERMIT $9 / 8OO �S`4. 9O
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � S�-8.43 NONE
PLAN CHECK FEE TOTAL FEE
�`" � �'Zci �
� l �.�� %� $4,61 $27.94
nTUREOFCONT C oR Ur aIZEDAGENr �DATEI WHEN PROPERLY V LIDATED THIS IS YOUR PERMIT
� ,Q� l�C(..�i�/ ��
UREOFOWNERpF ERBUILDERI IDATEI BLOG INSP DATE �
• � • CITY 0� farI�.)LCY , �
' PPLIC/1TIOt� C'Oft R�SII)[:tJTIAL BUILDIP�G PEftMITS
' ° (�1�L•W, �LTL"RliTIOtJS, IIDUITIOWS, OR REPAIIZS�
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OWt7�R: �\J��;�A�-� o C1 J3UILll�R: �
Address : � � `I � ` �.e-rv � � � ' Address : � S 3 (� � � �o '
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Tel. No. : �'(o p- ti i 1�. �'
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No.: 5treet:
LOT: L BIACY.: � ADDITIOP�: �QS O(�., 4'�`� ��
CORNER LOT: I2�SIDE LOT: S;�TIIAQ:: SID�YARDS:
Applica'rat attach "L-o i:his form 71��o Certiiicates of Survey of Lot and proposed
building loca�ian drawn on these Certificates. .
DESCRI PTI O(d OF BUI LDI NG
To Be Used �1s: '
�#�_"".."_l � ` -
�da�� Front: � �O � � aG �
Depth: �� Heights
�,�Q �-1ovS� Sc�are Feet: r�,c��.0 Cubic Feet: �%�±d
=�+-{--
�Front: � Depth: Height:
f
� Square Feet: Cubic Feet: '
�ype of Construction: le�p p d 1 Estimated Cost: $
/�., ,
7.b Be Completed: . �� g��
� �olO S Alt. A �Alt. B
Proposed Drive�aay iVidth If I�ew Opening Is Desired $ $ •
(SE� R�VERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all �.�ork in strict accardance with the City of
Fridley Ordinances and rulings of the Department oi suildings, and hereby
declares that all thc facts and representatinns stated in this application
are true and correct. See reverse side far aclditional infozmation.
� � � _ •�_,.,� � � G� � .
DAT�: SxGNATUr.E:
Stipulations: � . . . `V;
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BUILDING �PERt�IIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection
of any bvilding or structure, or for any addition to any existing building o� 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:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
� PLAN CHECK: 25 percent of building permit fee.
�
, DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
� Alternate A: Rsmoval and replacement of concrete curb and '
gutter only; Driveway width plus 6 feet x$14.50
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$17.20
�DDITIONAL INFORMATION
For the purpose of computing fees for bui.lding permi.ts, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from a
point six (6) inches below the floor line of the basement or the 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 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 $7.50 plus $.50 state surcharge.
� • • � ��_ ��
NOTE: Permi.ts for construction will be issued a minim�un of 24 hours from the time
of application`to allow for proper review of the proposed structure and of the
construction site.
A Certi£icate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
_: ' • � '`1
Application for a Certificate of Occupancy shall be made �ten (10) days prior to the
use or occupancy of any structure for which a builcling per.mit has been issued; and
sa3d structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
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�TiERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION
FLANNING AND INSPECTION DEPAFTMENT
CITY OF FRTDLEY, MINNESOTA
This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE
AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING
OFFICIAL can determine that submitted plans c�nply with the ENERGY CONSERVATION
DESIGN GRITERIA of the STATE BUILDING CODE (Sectian 6000). It is the APPLICANT'S
responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA
in the plans; submit product specifications, if needed to support the "R" and "U"
factors used; and to assure construction is per approved plans.
JOB LOCATION: �. � ( I '�' � Cd � _
OWNER/CONTRACTOR:
��
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ADDRESS: ' ���� ��` � 4 PHONE: �OD'�� ( 7
��.'"w`'`A..�.� ��a� I !� X 2. �
A. Determi.ne the Total Exposed �Vall Area as follows : 3���
1. Total wall window area N v�� x� =�q °�"° �,k^�'
, ru�! =
2. Total door area
3. Total sliding glass door area
4. Total fireplace wall area
5. Total wall frazning area Eaverage'.10%)
6. Total net wall. area above floox (average 90 0)
7. Total rim joist area
Subtotal: Tota.l exposed wall area above floor
8. Zb�tal foundation window area
9. Zbtal n�t foundation area above grade
Subtotal: Total exposed foundation area
GRAND TOTAL EXPOSED WALL AREA
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B. Multiply the GRAND TOTAL EXPOSED WALL AREA X.17 =
C. Determine fih e Total Exposed Roof/Ceiling Arua as follows:
10. Total skylight area
11. Total roof/ceiling framing area (10 0)
12. Total net insulated roof/cei.ling area
GRAND TOTAL EXPOSED ROOF/CEILING ARET�,
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D. Multiply the GRAND TOTAL EXPOSED ROOP'/CEILING AREA X.05 =
t�'�l� = a��; x�; ��a7z
/
� G' S
. �
Item I � � � � {
Item II � �
E. D�termine the "U" value of each segment (1-9) and multiply by the area as
follows:
1. '7 O g��U�� � S�� = 3 7e �
2. , I $ . g � ��U�� , I � - Z , i �,
3. a X��U�� d � �
4. o• X��U�� C = a
5. 3� i� Z� X��U�� , o�� �= z c�. S 9
6. Z � � �� X ��U�� , 0 l� � _ . � � l , z '�
7, �/�► � g��U�� � p'1 � = 2. 8�' .
� �8. / I� X ItU�� s 5 = � ��
9. t7/�1 � X IIUII e P� _ � �1 / �
ADD 1-9 FOR TOTAL WALL SEGMENTS = ITEM III Z��as�
F. Determine the "U" value of each segment (10-12) and multiply by the area as
follows:
10 . �' X
11. � � X
12. �°'� '�' � X
��U�� �
��U�� , � / �B
��U�� , ll %
ADD 10-12 FOR TOTAL ROOF/rEILING SEGMENTS
_ �,lo�
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ITEM IV S I � �"/ �
G. If Item III is the same as, or less than Item I, you have met the intent
of State Building Code 6006 (c) 2.
H. If Item IV is the same as, or less than Item II, you have met the intent
of State Building Code 6006 (c) 1. � .
z. Aad zt� z ���, 7 + it�► zz I�' ^ ���s %
J. Add Item III Z � � � � + Item IV � / ^ � � _ � � 5 ' � V
K. If the sum of I�ems III and IV are less than ItHms I and II, you have met the
intent of the Code for' total envelope system.
The undersigned, as applicant for a bui.lding permit, hereby affirms the above
information has been prepared and submitted by himself or under his direction,
hereby acknowledges the info�mation to be correct and accurate; and hereby
presents the information with required plans in support of the buildinq permit
application.
BY=
DATE:
L '� Y .
suerecr (T NO. "" �--
City of Fridley 5 3 4 0
AT THE TOP OF TME TWINS g U I L D I N G P E R M I T
�
� � RECEIPT NO.
� `L _ COMMUNITY DEVELOPMENT DIV. �/ / �
r � � PROTECTIVE INSPECTION SEC.
1 i �
� /'��1 � CITY HALL FRIOLEV $$432 NUMBER REV DATE PAGE Oi APPROYED BY
�----� • •,� 612-571-3450 910-F15 8/4/97 � �
JOB ADDRESS 6371 Jefferson Street NE
1 LEGAL LOT NO. BLOCK TRACT OF ADDITION SEE ATTACHED
DESCF. i$ 5 Christie Addition SNEET
2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE
Kay Wood 6371 Jefferson St NE 571-2781
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
D& D Home Improvement Inc 11773 Magnolia St NW, Coon Ra.pids MN 55448
4 ARCHITECT OR DESIGNER MAIL ADORE&S ZIP PHONE LICENSE NO.
757-7780 4840
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof House (19 Sq) 2nd Layer
9 CHANOE OF USE FROM TO
STIPULATIONS Roofing can be 2nd layer but not the 3rd.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCV (3qOUP OCCUPANCY �OAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTiiEET PARKING
I HEREBY CEFiTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 STA�LS GAFAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SUFTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1 19O � C)O
WITH WHETHER SPECIFIED HEHEIN OR NOT. THE GRANTING OF A PERMIT � '
DOES NO SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHAFGE
PROVIS NS O ANY OTHER STATE OR LOCAL LAW REGULATING CON- �(�,O.LS Fire SC �1.19
STRU ION OR HE PERFOR �CE .OF CONSTRUCTION.
/ � y� PLAN CHECK FEE TOTAI FEE
j �� License SC $5.00 $47.04
iGN a ocCO �AA(, OA RAUTNORIIEDAGENT IDATEI WHEN PHOPERLV IDATED TNIS IS VOUR PERMIT
� r �
SiGNATUiiE OF OWNEP UF QWNER BUILDERt IDATEI &n,_�p. INSP ry6TE
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CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDTNG PERMIT APPLICATION
ConsttucdonAddress: �p� ��� ��o �
Legal Description:
Qwner Name & Address:
Effective 1 / 1 /97
P� P '�
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Tel. # ��,�-�%��
Contractor: �4� N�mp Tmnrr�vcmnni-7 �,�. MNLICENSE# �s4p
Address: ????g :�aqnol i��raPt �S� � C'onn 12a�i r3c SSddR Tel. # 757_77Sp
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Len,gth
GARAGE AREA:
DECK AREA:
� :t �
DESCRIPTI4N 4F IMPROVEMENT
Width Height
Length Width Height
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Canstcuction Type: ����� ,�,/�'� ,��/� Estimated Cast: $ 1% 9�
�� �� ��,�-�� (Fee Schedule on Back)
Driveway C�ub Cut Width Needed: Ft. + 6 Ft = Ft x� _$
DATE: `� �F APPLICANT: Tel. # ��Z �% �%��
Pernut Fee
Fire Sutcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Controi
Park Fee
Sewer Main Ct�arge
TOTAL
STIPULATIUNS:
$ D-�S�
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$_�a
$
$ �� C�
$
$
$
$
$ �
CITY USE ONLY
Fe� Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$950 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Ait. "A" ar Alt. °B" Above
$450.00 Conservation Plan Review
Fee Deteraiined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
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COMMON VENT. VENT CONNECTOR A_N_D COMBUSTION AIR VERIFICATIOPI
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ()
The venting system is plastiGPVC and meets all current 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 fara
assisted and natural draft appliances.
The existin� combustion air is sized and installed to meet the cuRent codes
and manufacturer's specifications.
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturers specifications.
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
When installina a new ventina svstem, the undersigned hereby verifies that
it 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 ()
Is the common vent and vent connectors sized and installed coRectly after .
an appliance has been removed from the common vent and vented
separately as per current codes. Yes () No ()
Appliance Tvpe and Size/Gommon Vent and Vent Connector Information
Appliance #1 Type BTU Input ' Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS• (Describe)
HEATING CO: "
Signed By: - � Date :
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From: 763. 717 4872 , Pa�e: 1!1
ing �U�,A�NG
Date: 6r//20061:03:22 PM ��
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SUBMI'!' A COPY OF
YOUR STATE L�Gk�TSE s•rn� Lic�ss � Z...4�`3�� -�L') � � Da.� 3 ��, � 1O� ,
RR�'I� APP�.iCATTON `, r� ,/� L
ADDRERS: 7�� �Ui`+G � 1• , C���� N j 1�.a.�.4- TSPI' T�4�1�
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WORK $L�INO D4NE: f1t1�►'� �1���'
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1. r�aasur� wloorrlan
2. i'ro�CCd noor plen
3. List �' owalmal mcmbrJS to be �ed
FOR N6vV G71VS'l'RUCf10N WCLUDAVt3 DTsCK3.A�J
httpJlmr�.google.com/ma�l7vivv�att&disp�v�&att;id�).?.&th�lObat3b�0a2b6Sc6 6/7/2006
From: 763. 717 4872 , Pa�e: ?J7
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Date: 6!7/20061:03:22 PM
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Pa� 2 of 3
1. Sito PI�JSy�rey showieg t1� exiedn� atil�eluree mt+�
2. Two eem pf C(�trt�ctiol� p1a44
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QF WBIDDW TOB81A]$TALL� 13L1bi8E[LOF
Ai•1, FEES ARL� �AS�D bN VAi.UATI4N, Il�TG'LUDING THE COST OF LAB4R AND MATERU1IoS:
(USA�TG �E 1997 U.�C �� SCF�DUT..T�)
TOTAI..�O�3 VAY.UATION ���+'`� '`� •'- �� 1 UCCiJP'ANCY TYPE
i�iC $ 9�1. �� See Back Page for Fee Scbedole
. Review $ 65% of 9vi Iding Pcrmit Fee
surcharge S 3_ g 1 .001 tim�,a thv toml job valustion
�hazga S 1-� C1 .0005 x PCrmit valuatiort ]V,[inirifwr� $.50
mse 3urchal',�cj $ �• U() $5.00 (St�v LiF�ed Rpgiclenti�I ConbaCtore)
: Ghargo $ $1550 por 5AC U:sit (i�lans to 1V1WCC fot dataminatiar
rCutEscrow $ Q+6Rb RxS21=$
,ion Co�ol $ $4S0 Conscrvation Plan Reviow
: t'ee $ Fee Dabarmined by Engioeerin�
er M�in CEiarge $ Ag�cmeat n�y () Non Ne�e�sary ()
d Dup S l�� G� � Make checks p�yable toa Ciiy oPFridley Att�
la aw ar�canorr FoR n�un - rRac�sBa
he�+sbY apPly for a ba�ldifl�, permit and I aclrnowledge that tho inform�ticrn alwv4 i� comptotv �d as�w�te;
mformancs wit8 the ordinaaces �d ccdes of fi�e Gity of Fridley �d with tha M'mn�sot� Cons�uotiom Godea; tha
.tmit bttt only uv application for $ permit 8nd work is n�t tb start without a pe�tnit; th�d tltc work wili bq um a�t
mt �t thc case of al! work whlch requir� review and approv�l of plans.
OF
BUILDIIITG PERNIIT FEE SCHEDULE
The Cbie�' auilding Official shall, 6efox� issuwng permits far the erection of any buildin� or sbcct�+ttre,
ar for any ndditioxt to any elastia� bailding o� ssbructur�, or for any alLcnation or repair to any existiug
beu'iding or structur�, upan application therefore, require th� paymcnt by the applicant fo� guc� pennit
o� fi�s to the am�iunfi hesrezn b�low set forth �d in the mEan»er h�r�in provided to-wi�
http://mail.gaogle.com/mail/`lview�.tt&diep--�+ah&�ttid�.7.drth=l8ba�i620a2b65cG l/7/200b
.�� _ w Y � w �. �` � From: 763 717 4872, , Pa�e: 2/2 Date: 6/8/200612:11:57,PM, , �.` `
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For pormits indicated on ihe attacl�ed forms, please ch�rga our (choose from the tolfowing):
Ysa � MasierCard _ ' _
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Account Number t'�, c7 ,��, � � � 0 � - _ ( ! J _ � �
[xpiration Date (MontYi/Year) � / 0 �
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For more information, ple�s� call (763} 7G7-6478
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