P - 48173�Lil�dl�g
763-57Z-36d4
?�3-502-4977 F,A.�
From: 6517764378 Page: 2/2 Date: 1/11/2012 8:54:02 AM
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RESIDENTIAL APP'LICATIUN
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o�t r•c:r�e rrEw at�Nmrc�-n�sc� size oF
C7P'iT�iATt3 GHAI�JGES & — • -
Plan �eview
Fire 5urci�acge
�rucharge
I.icet�se �ut�iaarge
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CUrb Gwi Escrow
Ervsi�rn �ot�irol
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Sewer Ivlaia Charge
vtu.u�►'!'![xv, �4UDIi"�C �HE C�S7` O�
{LTSINI; THE I997 U.�C FEE SCHEDIXLE)
�A}S EE14[EN�' RF.TYlfN3F.T.dhiG . iT�MiT-
1. F�ei�tingFloorPluu
?. I'f'Opo:ed lioor plsn
3. f,ist af strodmtal rra4��t+mt� W i+s vew#
FoR rr�w cxfra�'r�tuc't'tctta trra vD� nECaCS.
ADI]ITIal�lw3 � PORCFD� R 'Rll�hiiP�
t• Site Fi� eho�uing q�q e�iapng atrutnucrs
aad proP�d P�J�
2. Two se�e ctaao�Oaxiaa►pd�au
3. �m'gy C;�inul�Oae
I+tXi WI1�DCIWS-YRUYIDE`iJ-�/ALUEAIJf?
�ra[tF�►c'1'TJRE3 srtcrc� ouwn�prW,
� ` 65% af �Yxilding Perrnit �'ee
� .OUI t:�rres the tcrtal job valu,ation
s ,_ .00� x Permit V�tuatian iulinun.wn ar .SU
� �5.{y0 (�taia Gices�sed Residential ContractprS)
� �2365 t,er SAC LTait (i�tmn.a w 1'►�V47CC for det�riaisusticm}
� � _it + 6 ft = ft x 5�25� $�,. .
� S45i� Gons�:rvation Plan lt�vicw
$ � I)eleimiraed by Eng�eering
� A�grdemc�A necet�e�Y ( } ?3on N��Y ( )
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TRiS 4, A1�F APfY.[CAT[UN EY}R A PE�RI�T�VC7C yALID UNTII. RCt{x:�;55E13
I hcreby apply for a buildi�g pecmit �d I s�owledge t1�at ihe inforniatlpn ehove is cvmpletc a�ud scetua�te: thst the work vuill be ut
coflfo�� with the vrdibances m�ci oade� ot #he City of Fridley and 'tti ihc M�ota Consh-uctian Cotiees; lhat I underst�d this is not a
Pe�iit but onty an a�tticaEivn for a perimil and work ' zloi to 'thv�zt a perrnit on si4e: that the woric ^uviII be in acoo�a�ee wittt tE�
appro�d plan in the case of all r� vi an� s 1 of,p�� t
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