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PRE 2010 DOCSCity of Fridley SUBJECT PE O. ® 13774 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO • ______ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 1 i � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-560-3450 910-F15 9/22/76 JOB ADDRESS 7575 McKinley Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 1 Bayer's Lakeside Addition SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Henry Buhl 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Cedar Bay Builders, Inc. 1700 - 3rd Ave., N.W., New Brighton 633-8800 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING KKK= Residential 7 CLASS OF WORK QAEW ❑ ADDITION El ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK WARNING Construct a 57' x 38' Dwelling and a 22' x 22' Garage oemre Gigging calf local uthit SEPERATE PERMITSTELEPHONE - 9 CHANGE OF USEFRONEATIK PLUMBING AND'919ft" REQUIRED OY L AN STIPULATIONS Provide a hard surface driveway. Provide c sod in the front and side yards. Provide a verifying survey before capping. Provide 2" x 8" rafters or approved Uzz bracing. Provide vapor barrier on ceiling. SEWER LOCATION: (Approx. 10' Deep) 8.5' South of Manhole (Inv. 893.8.) WYE ELEV: 893.78 TOP OF FOOTING: 896.78 'Minimum M. Ay ® _ WATER LOCATION:10' North of sewer service.' IMPORTANT— THE COY OI' MOM DOCS Nof CvuARANTE' "HE OFTIFY THE ACCURACY OF UTILITY LOCATIONS AND EUVAT GAN, IS ON R4GARDING CURB T141S DATA 15 FOR INFOEMAWN PUjzROSES O OV REMOVAL D REPLACEMENT posOms uMO R SHOULD VERIFY TH@ INFOWATION PCNING9. AT YE ON IME WL SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 R-1 1108 + 484 26,040 Total ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 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. $34, 355 $17.15 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- $104.16 /? $350.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $26.04 $497.38 40, SIGNATUREOF ONTROrORORAUTH RIz DAGENT (DATE) PROPERLY V LI ATED THIS IS YOUR PERMIT BLDG )NSP DATE �- SIGNATURE OF OWNER WNERBUI (DATE) y ✓ 16-1 01 V I= GERALD T.. COYNE 300 BRUNSWICK AVE S. GOLDEN VALLEY, MINN. MINN. REG. NO. 4741 INDUSTRIAL — JUDICIAL COMMERCIAL — TOPOGRAPHICAL CITY LOTS — PLATTING CEDAR BAY BUILDERS LOT SURVEYS COMPANY LAND SURVEYORS REGISTERED UNDER LAWS OF STATE OF MINNESOTA LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIS 5747 W. Broadway Minneapolis, Minnesota 55428 533-9922 1611Y'urgax8 i1t fifirt r tai low • Uft lay LAW 13) 2 4 - RAYMOND A. PRASCH 6917 IDAHO AVE. 4. BROOKLYN PARK,' MINN. MINN. REG. NO. 6743 INVOICE No. 5424 SCALE 1" O — DENOTES IRON 0 Denotes good Hub Set FO Excavation Only '---IN1P®RTAN NOTIlPf THE FRIDLEY ENGR, 1. DIVISION REGARDfr% CUpA ( R940VA . AND REPLACMMI AT t)RIY VAY OPENIM& � 1 ;. Cut 40F FUDW 10= Not tib U4 ACCURACY OF UMOY LO"T04 JIM REVAI M& IM DATA 6 RM O1tY JIM tS USMG R VWY Tim tlNOWA ►AON ON ME sm Lot 3, Block 1, BAYER'S LAAKESIDE 2ND ADDITIO►a ,r We hereby certify that this is a true and correct representation of a survey of the boundaries of the above described land and the location of all builldings and visible encroachments, if any, from or on said land. Signed Surveyed by u5 this 9 day of September 19 76 WT SURVEYS COMP Z! 4 ICITY OF FRIDLEY APPLICATION FOR RESIDENTIAL ALTERATION, ADDITION, OR REPAIR BUILDING PERMIT OWNER'S NAME: Henry Buhl BUILDER: Cedar Bair Builders Inc. ADDRESS: ADDRESS: 1700 3rd.Ave, N.W. New Brighton. Mn. 6,33 ,33 _6t4 NO: . P✓ STREET: McKinley St. N.E. Fridley LOT: 3 BLOCY.: 1 ADDITION: Bayers Lakeside Addition CORNER LOT: INSIDE LOT: x SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Home Front: 57' Depth: 381 Height: 17' Square Feet: 1108 Cubic Feet • Front: L Depth: Height: Square Feet;'e/6 'V Cubic Feet: V 46 47"� do Type of Construction: Frame Estimated Cost: $`03y To Be Completed: 90 days The undersigned hereby makes application for a permit for the work herein s ecified, agreeing to do all work in strict accordance with the City of Dill ridley Ordinances and rulings.of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: SIGNATURE:ga (See Reverse Side For Additional Information.) STI,0`G A. &*10 d ti 4 AAA 9e)ilI I ok74.®y ),18 5A� 3��• dy '519 z s ox� e «may, i CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE FINAL INSP. PLUMBING FIXTURE RATES: $3.00 N 7+ N Number Fixtures •(d $3.00 U Future Fixture Opening KN aN) $ O� Water x to $ Catch Basin x $5.00 k r.14 N q $ '5-- GO y p. •�01 $ Water Softener Heater $7.00 N New Ground Run Old Building x $5.00 N H x $5.00 V rON a U Nr, a)[ co O O O +r tl N$4 N .0 O a a ` A wm w U w4 0 i0 as lec 1st / 1 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE FINAL INSP. PLUMBING FIXTURE RATES: $3.00 RATE TOTAL Number Fixtures r�NO. /�� x $3.00 $ x!•00 Future Fixture Opening x $2.00 $ O� New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ '5-- GO 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 $ Job Address ;� S 7y �C Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. /0 , 19� OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST CJ OLD NEW )UILDING PERMIT NO. PERMIT NO. ` u t z— ROUGH INSP. Date Company /���p //i��" Signed By U (�9'+ '&1-1 Tel. No. /T'OK' GAS FITTING FEES: FINAL INSP. 1st 3 fixtures P x $3.00 $ _0c) Date Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ APPROVAL FOR PERMIT REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ + MINIMUM FEE FOR ANY PLUMBING PERMIT Is $7.50 State Surcharge $ .50 Js J TOTAL FEE $ •SO REINSPECTION FEE ($10.00) CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES i„„IIAL RATE SCHEDULE GRAVITY WARM AIR: Furnace Shell & Duct Work Replacement of Furnace Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU each add. 50,000 BTU Replacement of Furnace Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 STEAM OR HOT WATER SYSTEM: RATE TOTAL Job Address $12.00 $ / 7.00 $ 7.00 $ Department of Buildings 4.00 $ City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein $12.00 $_1Z specified agreeing to do all work in strict accordance with the City Codes 4.00 $ and rulings of the Department of Buildings, and hereby declares that all the 7.00 $ facts and representations stated in this application are true and correct. 7.00 $ W 4.00 $ Fridley, Minn. �,/� • 19 OWNER .!% j� �[/_ ! E��se�Ls�e�✓r KIND OF BUILDING 'J�Ae2� USED AS TO BE CO ESTIMATED COST �IdCG OLDtvY rw�AILDING PERMIT NO. PERMIT NO. WSJ DESCRIPTION OF FURNACE/BURNER HEATING or POWER P Tr S, Steam, Hot Water Warm Ai.r- No. / Trade Name Size No. Capacity Sq. Ft. ED HP Total Connected Load Kind of Fuel BURNER - Trade Name S' a No. �x/ ROUGH INSP. REINSPECTION FEE Capacity Sq. Ft. EDR BTU HP Date (.$10.00) RAY N. WELTER HEATING CO. FINAL INSP. L - 9- 7 Company 4637 Chicago Ave Date Signed By Mlnneap0 IS, Minnesota 55407 APPROVAL FOR PERMIT Tel. No. MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 Boiler & Lines up to 100,000 BTU $12.00 $ each addn. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ each addn. 50,000 BTU 6.00 $ OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures x $ 3'.00 $_ Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00 $ AIR CONDITIONING -i $ FAN HEATING SYSTEMS 1 See Fee Schedule $ VENTILATING SYSTEMS$ ALTERATIONS $ REPAIRS-) $ State Surcharge $ .50 TOTAL FEE r KIND OF BUILDING 'J�Ae2� USED AS TO BE CO ESTIMATED COST �IdCG OLDtvY rw�AILDING PERMIT NO. PERMIT NO. WSJ DESCRIPTION OF FURNACE/BURNER HEATING or POWER P Tr S, Steam, Hot Water Warm Ai.r- No. / Trade Name Size No. Capacity Sq. Ft. ED HP Total Connected Load Kind of Fuel BURNER - Trade Name S' a No. �x/ ROUGH INSP. REINSPECTION FEE Capacity Sq. Ft. EDR BTU HP Date (.$10.00) RAY N. WELTER HEATING CO. FINAL INSP. L - 9- 7 Company 4637 Chicago Ave Date Signed By Mlnneap0 IS, Minnesota 55407 APPROVAL FOR PERMIT Tel. No. MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 SUBJECT City of Fridley 72, 705�.8) AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO.�V77 Ir COMMUNITY DEVELOPMENT DIV. L 1 PROTECTIVE INSPECTION SEC. r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 10/31/94 JOB ADDRESS 7575 MCKINLEY ST NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 1 Bayers Lakeside 2rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE HenryBuhl 7575 McKinley St NE 786-4567 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Gates Roofing 4640 Ximines Ln N Plymouth MN 55442 550-0043 6793 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION C]_ REPAIR X ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (21 S Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 1 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 $1,575 .79 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. $37.00 Fire SC $1.58 PLAN CHECK FEE TOTAL FEE License SC $5.00 44.37 SIGNATURE OF CONT RACTOR OR AUTHORIZED AGENT (OATEI WHEN PROPEAY VALIDATED THIS IS YOUR PERMIT -a- /r -f BL G INSP DATE _9 SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) NEW [ ) ADDN Fee Schedule on Reverse Side ALTER V Construction Address: Legal Description: Owner Name Contractor: Qz52 697'-- S Address: (o CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application � 7 ZU e - Effective 1/1/94 Tel. # MN LICENSE # Tel. #.. -Z;-Za Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length _ GARAGE AREA: Length _ DECK AREA: Length _ OTHER: --r—r— IA - Width Height Width Height Sq. Ft. Sq. Ft. Sq. Ft, Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback. Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: (Cost on Back) = �; Driveway Cqrb Cqt Width Needed:-ft—+-4Ft = Ft x $ _ $ DATE: o -2 APPLICANT: Tel. # do Permit Fee $ -3 9. U o Fee Schedule on Reverse Side Fire Surcharge $ ..001 of Permit Valuation (1/10th%) State Surcharge $ '� % $.50/$1,000 Valuation SAC Charge $ $800 per SAC Unit " License Surcharge $ O C> $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE Residential APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work Commercial/I ndustrial 1.25% of Value of Appliance or Work Rate $ 30.00 $10.00 $10.00 $10.00 $ 25.00 State Surcharge TOTAL FEE Effective On January 1, 1997 JOB ADDRESS_ The undersigned hereby makes application for a permit for the work herein TOTAL specified agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and $ representations stated in this application e trend correct. $ $ .50 $ SS -e:) MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. OWNER- ?�� - j Ll BUILDING USED AS ESTIMATED COST--;O,=y'�� PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name_, Size No. BTU_ � s� ��v HP EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATING COMPAN a Signed By Tel No. Approved By Rough -In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Remarks: . List ALTERATIONS Being_ Done: HEATING CO: Signed By: Date: CEDAWEY AND STACK VERIFICATION The undersigned hereby verifies that the -existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No c ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: . List ALTERATIONS Being_ Done: HEATING CO: Signed By: Date: SUBJECTIT NO. City of Fridley 26057 AT THE TOP OF THE TWINS BUILDING PERMIT r -ffEVXW`T NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 j 612-571-3450 910-F15 5/15/98 JOB ADDRESS 7575 McKinley Street 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 1 1 Bayer's Lakeside Addition 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Doris/Hank Buhl 7575 McKinley Street NE 786-4567 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Franzen Construction 4250 5 Street NE, Columbia Heights , MN 55421 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 788-4071 2744 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION CR REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reside House & Garage (Vinyl) 9 CHANGE OF USE FROM TO STIPULATIONS Install building wrap and have inspection of same before covering. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS 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 $3.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $6,000 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTrrR S.TlkTE OR LOCAL LAW REGULATING CON- STRUC $112.25 Fire SC $6.00 OR THE PEIPQIRCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE / 3/ License SC $5.00 $126.25 SIGNATURE OFC N. AC OR ORAUTH IZED AGENT DATE( WHEN PROPERLY (DATED THIS IS YOUR PERMIT ?1/1_o OL09FINSP ^9 GATE S,GNATURE OF OWNER OF OWNER SUILDERi IDATEI Q NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Effective 1/1/98 Owner Name &Address: „ �� � Tel. # 0i o --2� '% Contractor: MN LICENSE # any`/ Address: aid � --S lct Tel. # �zz Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. ' GARAGE AREA: Length Width Height Sq. FL DECK AREA: Len Width Hgt/Ground Sq. Ft. OTHER:< - r Construction Type: UI A I �. Estimated Cost: $ OZYO (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: - / - APPLICANT: G Tel. # CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ n. ()0 .001 of Permit Valuation (1/10th%) State Surcharge $ 3.0 0 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit 'License Surcharge $ 041 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: $ /;26--.2S�