PRE 2010 DOCSBUILDING PERMIT
Village of Fridley, Minn. N? 2171
Date . ::��...... . .. .
Owne ...... .........::*.......... ". .
Address.........................................
Builder...........................................
Address.........................................
LOCATION OF BUILDING
No. *.f.�.f .. Street . �.": ... �...�.................. Part of Lot .......................
Lot ................ Block .... ..... Addition or Sub -Division v—.-.7� , , , , , , ,
Corner Lot ............ Inside Lot ... .... Setback .... Sideyardp+!�..~......�..:,.
DESCRIPTION OF BUILDING
To be Used as:
C Ail
.......... Front .. /. Depth . ` Height Sq. FL ........ Cu. Ft.........
................... Front ........ Depth ....ssem�.. Height Sq. Ft......... Cu. Ft. ........
Type of Construction Est. Cost �i .C3✓r. 1.. .
... .... .. 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 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 $./Y., ermit is hereby granted to ........................
• • • • . • • . • ............. to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
_Sx ,
Wii
........... Building Inspector
NOTICE:
This permit does not cover the. construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
City of Fridley, Minn..
BUILDING PERMIT No
742
Date: _
<a
Owner. /��...�.::�
Address _.. ._ _.. , Address
LO TI OF BUILDING
:No. Street,;� Part of Lot ._._ --------- ..........
_.._.__..__....._..__......_.
Lot .-----....- - .... Block ....._.... ...._................Addition or Sub -Davis ` 1 a,�° -•r
Corner Lot ........................ _....... Inside Lot ........... ack Side and . ...........
Sewer Elevation ....._.............. _.._..__.._.._._....__.___.__.. Foufridation Elevation ...__..---•----.._.._.._._._.....__..__._.....__.._....._...._
DESCRIPTION OF BUILDING
T U as
aseyY Y Front?_.. Depth ::. t ..... Height ..._.. Sq. Ft. _ Cu. Ft.a
f' ,pry
�........._ ....... ....... ei ht :..'....... Sq. Ft .... Cu.
Font Depth .
Type of Construction .._'"". �.`...:
��.�'�.,�.'.:��...... Est. Cost ..-,..��. _..�...v±e. i-......_... To be Completed ....._......... _._----------- _.
CAUTION
THIS PEPAM T DOES NOT AUTHORIZE VIOLAT-
ION OF ANY RRIvA-FE LAND COVENANTS AND
BUILDING RESTRICTIONS.
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 above set forth and in compliance with all provisions of
ordinances of the city 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
-- the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
' , gkF
_2�1-4r /tt Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
KIER
"M Ma arm- M We
LOCATION OF BBUILDING
No. `� S 3 street, Part
Lot �` Block. Addition or Sub.Div.
Corner Lot_, Inside Lot -*"� Set Back Side -Yard --
SEWER ELEYATI_�AL_.__------_-----___._______.--------.-__-FOUNDATION-ELEVATION
Applicant attach.to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUIMING
To be used, as:
Front / 6 Depth Height `
Sq. Ft. Cu. Ft.
Type of Construction _Tstimated Cost / �Z ® 2
To be comple 0 1 .
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions \stated in this application are true andrect.
DATE t r. - SIGNATURE 4�,I
Aedzt4
(AYche" of Fee costs can be found on the Reverse Side.)
1
SUBJECTPE
N0.
City of Fridley
®13254
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
ISRECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION
r PROTECTIVE SEC.
1 . �
i._•. �'�,,, CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED By
L J` 612-660-3450
910-F15
10/9/75
JOB ADDRESS 4513 Main Street N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
3
Plymouth Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Robert A. Keisling 4513 Main Street N.E.
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
D. F. Vizecky Contracting Co., Inc. 2659 Dupont Avenue South, Mpls.
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 ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Reside Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY'GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Aluminum
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
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
$3,750
1.88
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.
$24.00
PLAN CHECK FEE
TOTALFEE
$25.88
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PR PWALILDED THIS IS YOUR PERMIT
r
, /6-- 7 )—w
BLDG. INSP GATE
t SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
1
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: Robert A. Keisling BUILDER: D. F. Vizecky Contracting Co., Inc.
ADDRESS: 4513 Main Street N.E.
NO:. 4513 STREET:
LOT: 4
ADDRESS: 2659 Dupont Avenue South, Mpls
Main Street N.E.
BLOCK: 3 ADDITION: Plymouth 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:
Reside House Front: Depth:
Square Feet: Cubic Feet:
Front• Depth:
Square Feet; Cubic Feet:
Height:
Height•
Type of Construction: Aluminum Estimated Cost: $ 3,750.00
To Be Completed: 1 month
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict accordance with the City of
Fridley 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• 10/8/75 SIGNATURE: K. J. Walker - Manager
(See Reverse Side For Additional Information.)
4
6. 9. W izzak y 6ont2aetin y 67o., Ina
825-6616 2659 Zu#onE c4m. eSo., Ainma iak A(inn.
o y 5 i 3
w U to be-- Nkp 6
CeU
%Zvm-,�t
sc Ot
0 3750
11*
SUBJECT
PERMIT NO.
City of Fridley
x
22 3 26
AT THE TOP OF THE TWINS*M
; P E R M I T
r
COMMUNITY DEVELOPMENT DIV.
r i PROTECTIVE INSPECTION SEC.
i r
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED By
612-571-3450
910-F15
31494
JOB ADDRESS
4513 in Street
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
3
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
571-4620
Michael Powers
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE El. REMOVE
8 DESCRIBE WORK
Wreck 24' x 24' Detached Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Clean site of all demolition debris.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$15.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
SIGNAT EOFCONTRACT R R AUTHORIZED AGENT (DATEj
WHEN PROP RLY VALIDATED THIS IS YOUR PERMIT
BLDG INSP DATE
SIGNATURE OF OWNER iiF OWNER BUiLDERi IDATEi
CITY OF FRIDLEY
MOVING [ ] OR WRECKING [x( APPLICATION
Job Address • L��l 3 �/� ,n �� r" ���r l5 ✓
Legal Description:
Owner & Address: %�'� �'� � % -T 1'u -✓ 5 Tel . # 5--7/
Contractor: f�'' �'� lr�g � l "� �"� 'ISI._, #
Address: State License #
DESCRIPTION OF BUILDING
Living
Area: Length Width
Garage
Area: Length a L� Width Z�_
Other: Length Width
Estimated Cost $ % O c",
Height Sq. Ft. Cu. Ft.
Height / Sq. Ft. A" -7 / / Cu. Ft.
Height Sq. Ft. Cu. Ft.
Approx. Completion Date L1 -/5'=S
UTILITIES TO BE NOTIFIED
City Water/Sewer Mpls. Gas Company Northern States Power
571-3450 [ .] 372-4720 [ ] 566-9120 [�/q
Water Bill Paid: Yes [ ] or Collect [$
Moving Route:
] Initials
U S West
663-6000 [ ]
The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing
to do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State
Code which requires any water well on the property to be sealed by a State licensed water well driller, and
hereby declares that all facts and representations stated ins application are true and correct.
3 c,- W, Y 'j
Date
Moving: Principle Building into Fridley .
Accessory Building into Fridley .
Through, within or out of City
Signature
$ 80.00
$ 20.00 Minim= Fee: $15.00
$ 15.00
Wrecking: For each 1,000 cubic feet or fraction . .$ 1.25
For structures which would be impractical to cube, the fee shall be based on
the total cost of wrecking at the rate of $6.00 for each $500.00 or fraction.
Pmr FEE: /�
SMI. .:
SUBJECT
PERMIT NO.
City of Fridley
22475
AT THE TOP OF THE TWINS
BUILDING PERMIT
.,:
COMMUNITY DEVELOPMENT DIV.
/ (j
_
r ~ PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
L 612-571-3450
910-F15
5/4/94
JOB ADDRESS 4513 Main Street NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
3
1 Rearrangement of Plymouth SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Michael Powers 4513 Main Street NE 571-4620
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
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
CJ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 361 x 26' Garage
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide a hard surface driveway. Provide smoke detectors in dwelling
adjacent to all bedrooms and in basement. See notations on plan.
WARNHIG
Before digging .call 10T
all utility locations
454-0002
REQUIRED BY LAW
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$14,976
$7.49
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
Fire SC $14.98
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$162.00
PLAN CHECK FEE
TOTAL FEE
$184.47
SIGN URE OF CONTR C OR OR AUTHORIZED AGENT IDATEI
RLY�VALIDATED THIS IS YOUR PERMIT
BLDG W P BATE
�- S�GNATUR OF OWN R IIF OWNER BUILDER, IDATEI
NEW [ ] Ef fective 1/ 1/94
ADDN CITY OF FRIDLEY
ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: --
Legal Description: L ,? iI'A, f, -s— T v
Owner Name &Address: 0 Tel. #
Contractor: W MN LICENSE #
Address: S^ i- Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height "Sq. Ft.
Length Width Hgt/Ground Sq. Ft
Corner Lot N Inside Lot [ ] Ft. Yd Setback 3 Side Yard Setbacks 3
Type of Construction:--'
��^Estimated Cost: $J
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + Ft = Ft x $ _ $
DATE: S- �L� APPLICANT: `��`''��'/ Tel. #
il.�,•/c
CITY USE ONLY
Permit Fee $ 11�,2 06 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 $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Aft. "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:�"E-
1 CI -3
FA
SUBJECT
City of Fridley
32169
AT THE TOP OF THE TWINS
BUILDING
PERMIT
E
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.
72® Vil04
�3_7 ' '7
r
1
i CITY HALL FRIDLEY 55432
I "\
NUMBER
REV
DATE
PAGE OF
AdPROVED Br
612-571-3450
910-F15
9/17/01
JOB ADDRESS 4513 Main Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
3
Rearrangement of Plymouth SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mike Powers 4513 Main Street NE
763-571-4620
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION IR REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (13 Sq) Tear -off
9 CHANGEOFUSEFROM
TO
STIPULATIONS
Underlayment must comply with
the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CON T.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
S0. 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
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
$1,393
$.70
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.
$50 95
Fire SC $1.39
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
AL FEE
/I
__14 /
I 53.04
SIGN AEF1CON'R CT AORAUTHORIZEDAGENT MATE.
HE P O Y VA ID ED THIS IS UR PERMIT
s /
B G INSP TIA TE
GNATURE OF OWNEFFOF OWNER BUILDER, iOATE.
FA
NEW [ ] Effective 1/1/2001
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 4- yi< JI L
Legal Description:
Owner Name &Address: f/1'/ �` �� f (��..�i r S Tel. # -76 3- Sr-? /' `� C? o
Contractor: MN LICENSE #
Address: Tel. #
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. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: 6 once r- Lie-6nr -0 rF I -� S �j,- F -
Construction Type: 5, ^ sls
yp A 5 Estimated Cost: $
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $
DATE: cS APPLICAN rF- Tel. # �b j- 5�7�'- yGt a
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$_ S-6- 'Fee Schedule on Reverse Side
$ / 3 /c► .001 of Permit Valuation (1/10th%)
$ 1,70 $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. T" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$