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AF - 44830S�a�E�. .,,,- ,P�rr N . City of Fridley 7�; �� q. AT THE TOP OF THE TWINS g U I L D I N G P E R M i T r � . � � COMMUNITY DEVELOPMENT DIV. `�� V PROTECTIVE INSPECTION SEC. y � i "" , r �� , , , _ ' � �'��i � CITV HAIL FRIDLE� 55432 NUMBER AEV DATE PAGE OF APPROVED BY �---'�'� �'' 612-571-3450 910-F15 11/30/94 / / J08 ADDRESS LG�T 1042 Fillmore ��e NE t LEGAL �OT NO. BLOCK TRACT OH ADDITION SEE ATTACHED DESCR. 9 1 Hillwind Townhomes SHEET 2 PROPERTV OWNER MAIL ADDRESS ZIP PHONE Twin City Townhomes, Inc. 1250 E Moore Lake Dr, Fridle 55432 572-8872 8269 3 CONTRACTOF MAIL ADDRESS Z�P PMONE LICENSE NO. Same d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LtCENSE NO. 5 ENGtNEER MAII ADDRESS ZIP PHONE IICENSE NO 6 USE OF BUILDING Residential 7 CIASS OF WORK Cl_ NEW ❑ ADDITION O ALTERATION ❑ REPAIR ❑ MOVE O REMOVE X 8 DESCRIflE WORK Foundation for Townhouse and Gara e 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Paid Park Fee of $750.00. Variances approved on 8/15/94 to reduce the front yard setback from 35' to 30'; reduce setback from 25' to 18.9' for front patios; and to increase the width of the driveways from 32' to 36'. TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTHICAL, PLUMBING, HEATING, VENTIIATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONS7RUCTION zONiNG Sa. FT. CU FT. AUTHORI2E0 IS NOT COMMENCED WITHIN 60 OAVS. OR IF CONSTRUCTION OR WORK IS SUSPENDED Ofi ABANDONED FOR A PERI00 OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTFEET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STA�LS GARAGES AND KNOW THE SAME TO 8E TRUE AND CORFECT. ALL PROVISIONS OF LAWS VALUATION SUFTAX AND ORD�NANCES GOVERNING THIS TYPE OF WOfiK WIIL BE COMPLIED WITH WNETHER SPECIFIED HEREIN OR NOT. THE GAANTING OF A PERMIT 1H ZOI.7H DOES NOT P ESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEFMIT FEE SAC CHARGE PROVISIO f ANY OTHER T OR LOCAL lAW REGULATING coN- Fire SC STRUCTI R THE PERFOR E Of C TRUCTION 19H. O PLAN CHECK FEE TpTAL FEE � � License SC $5.00 $1,030.30 + PF si NATUFlE FCON� 70�70pAUTMO:��ZEDAGE �oAT � WHEN PROPER VALI ATED THIS IS YOUR PERMIT _ ��Gv, u� /2-/-9y SiGNATURE OF OWNER UF OWNEA BUILDEP� �DATE� BL G iNSP D6TE a - t=✓ NEW {).��' 3J. 2�_ 3 z_ ��.�, ADDN [ ] � �i � � � ��, 2- �7 C[TY OF FRIDLEY ALTER () SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Constcvction Address: � _ Legal Dcscription:"'�'�N'��: Q Owner Name & Address: Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: �'�l.��!./�! .�� . � . i� _ ./T r' �� -. �� Effective 1 / i /94 ��i �� . Tel:1# S7Z-887 _ MN LICENSE # �Z�o '�I Tel. # �7 Z -$$1�_ Attach to this application, a Cerf�'icate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IIVIPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length R�idth iCa� uw r�►4-r, Olv Corner Lot [] Inside Lot [] Ft. Yd Setback Type of Construction: Approx. Completion Date: Hgt/Ground Sq. Ft. -- � � �',�� i ��Y�� 10•��% 3��" • � � • �� Side Y��etbacks � � � D .9b �a�r�a c�: $ l � ��i . 2 �` (Cost on �ackj Driveway C Ctiit id Needed: Ft. + Ft = F —$ DATE: / � APPLICANT: Tel. # �7Z - f��%�_ Permit Fee � . S � � � � � �` . �' C� Fire Surcharge I `� 5� � $ � � . �� State Surcharge '�Z � d � $ � ,. � � SAC Charge ��ov $ C5�? License Surchargec� b $� Driveway Escrow $ Erosion Control $ Park Fee ��° $ 7 ��. av Sewer Main Charge $ --�— `i. ��_ Fee Schedute on Reverse Side .001 of Permit Valuation (1110th%) $.50/$1,000 Valuation $800 per SAC Unit $5.00 {State Licensed Residential Contractors) Alt. "A" or A1t. "B" Above $450.00 Conservation Plan Review Fee veterminea by Engineering Agreement Necessary [ ] Not Necessary � � � - 3c� �� u _� TOTAL $ � � '�"�'' ` �� J a0• ,30 STIPULATIONS: _ , . .. � SuBJECT O� c�cy of Fridley � �, �� 5 AT THE TOP OF THE TWINS � U I L D I N G P E R M I T , r � � � � COMMUNITY DEVEIOPMENT OIV. RECEIPT NO. • / r � � � PROTECTIVE INSPECTION SEC. /., �� 1 � �� - � � /"�1 � CITY HALL FRIDLE� 55432 NUMBER REV DATE PAGE OF APPROVED B� �"""�'� �'' 612-571-3450 sio-Fis 3/2/95 / / JOB ADDRESS 1042 Fillmore Court NE 1 LEGAL ��T NO. BIOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 Hillwind Townhomes s"EET 2 PROPERTY OWNER MA1� ADORESS 21P PHONE Twin Cit Townhomes Inc. 1250 East Moore Lake Dr Fridle MN 55432 572-8872 8269 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDfiESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE IICEMSE NO. 6 USE OF BUILDING Townhouse & Gara e FULL Permit 7 CIASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE X 8 DESCRIBE WORK Full ermit for 27' x 32' Townhous and a 17'6" x 18' Gara e. Foundation ermit issued 11/30/94. 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. Paid Park Fee of $750.00. Variances approved on 8/15/94 to reduce the front yard setback from 35' to 30' and to reduce setback from 25' to 18.9' for front patios and to increase the width of the driveways from 32' to 36'. TYPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTR�CAL, PIUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THI5 PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SQ. FT CU FT AUTHpFIZED �S NOT COMMENCED WITHIN 60 DAYS, OR IF COIVSTRUCTION OR WORK IS SUSPENOEO OR ABANQONEO FOR A PERIOD OF 120 OAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTf1EET PARKING I HEREBY CERT�FY THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPUED �72 � �99 $36. �FO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES N T PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE Fire SC PROVI O S OF ANY OTHER ATE R LOCAL . ULATING CON- STRU N OR THE PERFOR N OF CO UCTION. ��FOI..00 PAID 72 � 80 Zf��_�� PLAN CHECK FEE TOTALFEE �L�� License SC $5.00 $515.20 S�GNATUREOFCON'RACTOAOAAUTNOA�2EDAGENT �onrEi _ WHEN PFiOPER VALIDATEO THIS IS VOUR PERMIT - ' � .__'� _��j�JlYYl �7 S�GNnTUREOFpWNEAi�%OWNERBUi�DERi - iDATE� g�p iNSP qaiE _ �......�. � NEw i l ADDN [ ] �-�R t l ConstivctionAddress: I.egal I�scriphon:�� `` Owner Name & Address: Contractor: Address: LIViNG AREA: GARAGE AREA: DECK AREA: OTHER: Effective 1/i/94 CITY OF FRIDLEY SINGLE FAMILY AND DUPLE3�.S R-1 AND R-2 , � Building Permit A�lication � �� - . ,.--- ,�n � . , ,.. �,�_ Tel. # 5 T z. "��7 MN LICENSE # �� 0 9' —r-- �Tel. # �7Z –�S 8 7 Z. Attach to this apptication, a Certifi�ate of Survey of the lot, with the proposed conshvction drawn on it to scale. DESCRIPTION OF IMPROVEMENT ��f7 �?SG �3h'/s' a Length �7 � Width 32 ` Height /y� �. � Sq. Ft. Length � ��( �� Width /� , Height Sq. Ft. 3/S Length Width Hgt/Ground Sq. Ft. Corner Lot [] Inside Lot (] Ft. Yd Setback Side Yard Setbacks i�ype of Conslruction: ]��t./ Estimated Cost: $ 9/� � tI f. a 3 A�rox. Completion Date: FDN �Yi �4% 7� _. (Cost on Back) �2� �% l � Driveway Curb G�t Width Neecied: Ft. Ft = x$ –$ DATE: APPLICANf: Tel. # o,,n � F,o�,�' ��. � � 9�� Permit Fee . Fire Surcharge State Surcharge SAC Charge License Surchazge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: — `/Q�, `� � �%'`�' $ `�?Z, �0 � �f0 $ ! S :�, �' $ $ $ ,9�0 � $ �/�, 2� �MM_ `� � �!_. �a� � .� ` _� u-N'D .��) I OC� - /�1c�.G��:: ; Fee Schedute on Reve�se Side .001 of Permit Valuation (1/lth�h%) 1 O��R: C- /� . s � $.50/�1,000 Valuation �� = $800 per SAC Unit ' = $5.00 (State Licensed Residential Conttactors) Ali. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Ne�essary i] Not Necessary [ l .� .� } _ ,�� '`�D/, Ul> 7.�: �c ��. �o ,� . 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S N a � � � �— � �`-�-�.n.� �' Z� t� � a � t W � � � � � m � O g � w Z � W N a W � � Z F V `s Y Q � Q W OQ "' Z o� y LL Y F- m� �j U og a � � � � b � l�s. � 'ma � `a � � m c o a � � ac � �` � .�. c � �� c �� 7 o� > � v 11 F— � � W d � � O J � _ U W z O 0 w J J H �� Z :W m � � W aC � � x LL � O � w m � � . • Z � Y � ¢ � i� � � � � � � T � � `� � � w � � Q m O � � � O F- W F- Q � O z � W k- Q � W � � H x LL � Z m � � J a � -� � . �� L 'p Y U ' � Y : m -� � Y �, . �� °�; � 3 ; � � i N U � � c � � � � � � `p ``p� J C U i � � J � � � U '� 1 a � � Q C � � � � O � � 3 � E � � � o ' � a � a� - m o � � � � � : m 'a� � a� . m � i � � i m � � 'O C � v ' N N i H ani i �, � � I � r--^ � 1 � . � � � � G 3 O � � � � � ¢ v a> N � � C �a .� m 1� � � � � � 0 � Z ,� H � � �� W a � I� i" � e\ � � � � � �, °' � .� o � p C Z tL J � W F-- N c�-'6 � C � L rn � � Q � � _i � k= Q � p tn � ll" � W � �, p ��--� W U Z in � � S � m W > _ ~ - � O � fii � � �� Z � w n �n Q � a O -p � O O � 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 i. v�ri �►� � � o� o 0 0 � fA - EA EA tH EA 69 69 EA � Ef3 � V) Efl \I I I t ( I ( I I� I I Z I N � i U N � �3 N v' 3 U Q> X �C � U � C L1L ` � 'Q �' � � � � L� Q W � C N Z � C � C � � � � � m y� c� c`•� Y d`m a � N m � � � � � � � C � O . � � � O m � � f- _ = ca �` � a> O '- °- .0 fl N N N� ��[ T 3-o u`� 3� c E u, u, v�. z O m m(� cr c'n �� c7 c7 m o � � � � � � Z O H ¢ � w h- J � Q � � Z U L Q C U (n � 7 � Q � Q � N a Q cu W O (n O O � N � � Q X � Q O � � � ,U W j � O O C � o � Q w w ti � F-- � H sue�ecr PERMI c�ty of Fridley �,�� 4 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � _ „ , � RECEIPT NO. • COMMUNITY DEVELOPMENT DIV_ � � L_��"' ' r � � PROTECTIVE INSPECTION SEC. 1�'K� � � � _ ' ' �'��1 � CITY HALL FRIOLE� 55432 NUMBER AEV DATE �AGE OF APPFOVED BY �'"'"�"� ,'' 612-571-3450 9�0-Ft5 5/1/95 � � 10B ADDRESS 1042 Fillmore Circle NE 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCfi. 9 1 Hillwind Townhomes SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE �tain City Townhomes 755-3976 3 CONTRACTOR MAIL ADDRESS 21P PHONE UCENSE NO Neisen Construction Inc 418 Hollyhock Ln, Hopkins, MN 55343 933-6818 3161 4 ARCH�TECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDFESS Z�P PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASSOF WORK ❑ NEW O ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WOFK Replace party wall; seal for smoke 9 CHANGE OF USE FROM TO STIPULATIONS TYPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PlUM81NG, HEATING, VENTILATING OR AIR CONOITIONING. TMIS PERMIT BECOMES NULL AND VOID IF WOFK OR CONSTRUCTION ZONING Sa. FT CU. FT. AUTHORIZED IS NOT COMMENCE� 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 t 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 SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �Z�OOO �L.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEfiMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @ STRUCTION O�HE PERFORMAN E OF O�VSTRUCTION ��FS.00 Fire SC �p2.00 1 PLAN CHECKFEE TOTALFEE ��z�� License SC 5.00 $53.00 SiGNATUAEOFCON'RAC,IOAOAAU MOA�2EDAGENT IDATE� WHEN PFOP L�LIDATED THIS IS YOUR PERMI� SiGNATURE OF pWNEA UF OWNEA BUILOEAi �DATE� DG iNSP �tiTE .. NEW ( ) Effective 1!1/95 -ADDN .. [ � GITY O� FRIDLEY' ALTER [ ] . SINGLE FAMILY �ND DUPLE°�ES R-1 AND R-2 - . � . �f 57� : . Building Perin�t ApPI'tca.don - Construction Address: C� � . ; �(��'Z . �.�tC�� ` . � .: Legal DescrigtiEOn: � Owner,N.ame.& Address: Contractor: _1/�� (�' < Address:. . v . TeT. # `;Z.S.S� 3 ? � MI�I'I:ICENSE # . .,:?I (�,z! : ��Tet. # i� �'� . �:�'..�3. ��' 18" � �. - , . Attach to this applicatior�, a Certificate of Survey of the lot, with the proposed construction .drawa on it to scale. . DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length VYidth Height Sq. Ft. D�CK AR�A: ��Let�gth � � Width H Groiuid Sq. Ft. • � OTHER: ' � Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ a2 o U D. o v Approx. Completion Date: l5'� (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: 7 APPLICANT: ` � �� /�/��,1 e.v Tel. # .�3��% � Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ �S-vc� $ �� $ /� D � $ $ �_�� $ $ $ $ $ � �_�� CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/ lOth %) $.50/$1,000 Valuation $850 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ) i . , � _ Ct I l OF FRiDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287 September 2 i, i 9G5 Twin City Townhouses Inc 1250 E Moore Lake Dr NE Friciley, MN 55432 Re: Final Inspection at 1042, 1046, ] 076 Fillmore Circle NE, Fridley Dear Sirs: A final inspection was conducted on September 21, 1995 of the above noted acidress. We found that the construction of the building unit camplies to the best of our knowledge and belief, with all the requirements of the building codes of the City and the State of Minnesota relating thereto, �and permission is hereby given for the occupancy of said unit. If you have any questions on this matter, please feel free to contact me at 572-3603. Sincerely, ' i GGe L• !� � Barry R' sch Building Inspector ve �� . � SuB�ECT . . � �� City of Fridley ,� 572-36�� T"E TW'"S g U I L D 1 N!G P E R M I T � `v _.�� COMMUMITY DEVEIOPMENT OIV. r � � PROTECTIVE INSPECTION SEC. � � , � � �"'1 � CI7Y NALL FRIOLE� 55132 NUMBER �"""�� ,'' 612-571-3450 9t0-F15 J08 ADDRESS 1042 Fillmore Circle NE t LEGAL �OT NO. BLOCK TRACT OR AODITION DESCR. 9 1 Hillwind Tow 2 PpOPERTY OWNER MAIL AOORfS$ 3 CONTqACTOR MAI� ADDRESS To� Gun Inc 5014 Parri� Ave NE Rng,Qr� 4 ARCMITECT OR DESIGNER MAIL ADORESS 5 ENGINEER MAtL ADDRE$S 6 USE OF BUIIDING Residential REv 12/31/98 21P PAGE OF � � PHONE PMONE �E�fT NO. ' 28802 R g� y � AGVROVED B� SEE AT7ACHED SHEET LICENSE NO 78 1� LICENSE NO. IICENSE NO 7 CIASS Of WORK ❑ NEW O ADDITION O ALTERATION 8K REPAIR O MOVE O REMOVE B DESCRIBE WORK 9 CHANGE OF USE FROM STIPULATIONS Call for building wrap inspection before coyering. SEPARATE PERMITS ARE NEOUIRED FOR ELECTRICAL, PIUMBING. MEATING. VENTIIATING OR AIR CONOITIONtNG THIS PERMIT BECOMES NUIL ANO VOIO IF WOpK OR CONSTRUCTION 20NING AUTHOFi12ED IS NOT COMMENCED WITHIN 60 OAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO fOR A PERI00 OF 120 DAVS AT ' ANV 71ME AFTER WORK IS COMMENCED. NO DWIG. UNI75 1 NEREBY CERTIFV TMAT I HAVE REAO ANO EXAMINED TMIS APP�ICA7IQN ANO KNOW TME SAME TO BE TAUE AND CORRECT. A�L PROVISIONS OF LA1MS VAI.UATION AND OROINANCES GOVERNING THIS TVPE Of WORK WI�L 8E COMP�IED WITH WHETMEfi SPECIFIED HERE�N OR NOT. TME GRANTING OF A PERMIT �SOO OOES NOT PfiESUME TO GIVE AUTMOfiITV TO VIOLATE OR CANCEL THE pEqMIT FEE PROVISIONS Of ANY OTHER $TATE Op �OCAL LAW REGUTATING CON- STRUCTION Op THE PEiiFORMANCE OF CONSTFUCTION y�21.O0 P�AN CNECKfEE __ ___ Licen�e/5�4 S�GN�TUpE OF CON7RA(;TOp ON �UTHOQ�ZEO �GENT �o�rE� �D�TE� SO.fT OFfSI STA�LS SURT� $.50 $5 �,00� �$2 OCCUPANCVLOAp CU f T REET PARKING IGARAGES $.50 IS YOUR PER iT / �� r�n T E ,. NEW ADDN ALTER � � �l [] CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: �O%� Legal Description: � Effective 1/1/98 � � b v�. Owner Name & Address: , Tel. # Contractor: ��1/� MN LICENSE �# Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. �t �i�,.,�-53� LI�ING AREA: I.ength Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: l/ Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: � .--�d�APPLICANT: Tel. # `�6 �� CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ .� � �' $ .'�Z% $ �� $ $ $ $ $ $ $ � � Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.SO/$1,000 Valuation $1000 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 [ ] �� Build�ng Inspections 763�572-3644 763-502-4977 FAX bATli. �/IO/07 SI"iE ADDRCSS �� 'I'HIS ArNI.tCAN1' [5: PRdPERTV QWPIER/ TENANT From: unknown Page: 3/10 Date: 9/22/2009 9:35:48 AM BUi�,DIIYG Permit No � SI ENTIA►L A;PPL�CAT��N Received By: ��TY OF FRIDLEY oate�c : 2 Z� FFFEC[]VC 1-1�49 Y UR -MMI. AL1D °SS �.,;r � �I � ` �. .� ..�� `�� t � c � — O OWNCIt �N7RACfOR J. �I �[ /� ZU�"Q �(/� •.Vl� � �4 � VR NAME �� Stl9MIT A COPY OF srA�n� 4.ICFN5E N, Yt)UR Sl'AT� LICGNSE AND CERTIFICA'fli OF A�DRhSS:ZJI�E 1NSURANCE WJALL' �yG�.� PROPERTY TYPB 0 S1NGL� FAMILYMF.W CpNSTRUCTION O'1'Wb FAMILY/N�W CnNSTRUCI'16N �ERMIT TYAE � �DbiTtON O GARAG O pASEM6NT F1N1S11 B'Rf)OF O DECK q �DlNG CITY, TYp� OF WORK: � NEW HQME CONSTRUCTInN 0 Al)DITION B"6AAlN',�IiNAN('F1RF,PAIR O RFMIM�LIN�i DLSCRIHE wpRK BEING DONF; 4 , SIZTi OF iMPROV�ME:N'1' I.tiNG'1'H � WtD'TH p QH�J SEONI.Y NUMBBR OF SQUARES _-7� B'FlOUSE ec GA ItAGE ,�� 0 A?TACHED OARAGF PR(?POS��]SIZF; 0 DCTACH�bGARAGE PItpPQSEp HEIGHT: 31DING — Yinyl OSo�I ❑ Alwninum ❑ 7rim C (hher O F�cia WINbOW3 IN CXISTING OPENINGS OYca GNo l.C�(:ATlp�1 UF WINDOWS OR fOR N�W OPENfNGS-OESCRIB� SI'LF: bF t)['ENING CHANOES dc 7YI'C Of� WINDOW 70 9F. IN31'ALL6D. �.� NUMlB�R t�r WiNL�UwS ALI, REES ARE �ASED ON VA�riiATtUN, iNC4UDINC TH� CQST 0�' y(�15�NG T1lE 1997 U.B.0 FEE SCHEpl1LE) POTAL JOB VALUATION S�� l �� 'J QCCLIP� Fermit Fee Plan Revitw Fire Surd�arge Surchuge License Surcharge SAC Charge Curb Cut Escrow �t�gion Conhql Pork Fee Sewer Main Charge EXP ❑ OItAIN TILE O pTH�R � �a QASFMkN1' ItRMUDELING Sl18Ml'1'� I. Fxispn8 floor Plen 2, Proposcd floor plen 3, Lial nf svucwrai members �v bc uacd FpR NBw CONSTRUCTICIN iNi1.UDIMG p�CKS, knniTlflNS_ � PAR['HFS CU9Mfl'• I. Sile PIan/SuNey Showing {hC exieling sWcWrc9 and P� R�Jeat. 2. Two �ts of amavuction pIM, 3, Energy Ca�ula�Mns AND MATERIALS: 3 �a ?�,"�.�i See Beck Page for fec Schedulo $ 65°�ofl3uilding Pertnit Fee S .ODI rimes the total job valuation S .0005 x Permit Valuatiun Minimum 5.50 S 55.00 (SMte Licensed Residential Cantractors� S S200fl per SAC Unii (Pl�s W MWCC for determins[ion) s tt+6Q= ftxSZ1=S $ $450 Cbnscrvetion Plen Rcview S Fee T�etermined i�y 6ngineering S Agreement necessary () Non NeceBSary ( I 'I'HI� i!3 AN APPLICATION FOR A PERMIT NOT YAL1U UNT1L PROCESSCD 1 hereby apply for a buifding permit and I acknowledge that the infrnmAtion sbove is camplete and accurate; thet the work will be in eonfAnnanee with the prdinance� and ccxles of the City af Fridley end with �he Minnesc�ta ConStruction Godcs; that [ undentand �his is noc a permit but only en spplicadon for a permit and worlc is noe �,o s�art witltiout a permit on site, that tfie work witl be in accordance wirh thc approved plan in th� cs�e of all wark which roq� review and approva! of pl�ns. ,� ,, r, 5KiNA'IURt UP APpLlCANP `�_,� PLEASE NOTE: SEPARATE u