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PRE 2010 DOCSBUILDING PERMIT Village o� Fridley, Minn.g � Y Date7 ..................... OwnerT�!! J . t�.I[.l.A."c^... Address..................................... N° 2799. Builder. ....................................... Address......................................... LOCATION OF BUILDING No. ....... Street . .... ... ...................... Part of Lot . ............... . Lot .... ,/.%�........ Block ...�........... Ad tion or Sub -Division 1-6-W4C*-i&1 . ......... Corner Lot ............ Inside Lot ./.e ........ Setback Sideyard A* .,//� ,, , , , , ,, , , , , , , , DESCRIPTION OF BUILDING To be Used as: ..... Front ... Depth .... Iieight ......... Sq. Ft. 11449.. Cu. Ft........ . low DWI ....... • Front l ..... Depth .. Height ......... Sq. Ft. ;q- ®. Cu. Ft. ........ Type of Construction .. Est. Cos . YO.4.4'1) .......... To be Completed/ In consideration of the issuance to me of a p rmit to constru the buil ' described above, I agree to do the proposed work in accordance with the description above set fo –an in compliance with all provisions of ordinances of the village of Fridley. consideration of the payment of a fee of $. g'e�.. to construct the buildlr 1e express condition that the person to whom it done in, around and upon said building, or any p Fridley, Minnesota regarding location, constructic in the village limits and this permit may be revol ordinances. NOTICE: This permit does not cover the construction sewer or water. Be sure to see the Building Inc Y,.— , permit is hereby granted t .�� ...... . or addition as described above. This permit is granted upon granted and his agents, employees and workmen, in all work t thereof, shall conform in all respects to the ordinances of alteration, maintenance, repair and moving of buildings with - i at any time upon violatiorye�,any of the provisions of said :7et' Building Inspector installation or alteration for wiring, plumbing, gas heating, ector for separate permits for these Items. SUBJECT PERMIT NO. City of Fridley 12414 AT THE TOP OF THE TWINS BUILDING PERMIT s 1 RtQQELNO. `I L -_____ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 1 � I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L---- • ,`J 612-560-3450 910-F15 12./14/73 JOB ADDRESS 6341 Monroe Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 7 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ronald Brogger 6341 Monroe Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Leroy Contractors 3637 Oakland Avenue 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 1 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION LN ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE S DESCRIBE WORK Basement dug below crawlspace 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR MITRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQU RED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDIT[ NTNG. THIS PERMIT BECOMES NUL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 F.AYS, 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION I SURTAX AND ORDINANCES GOVERNINGTHIS TYPE OF WORK WILL BE COMPLIED. WITH WHETHER SPECIFIED HREIN OR NOT. THE GRANTING OF A PERMIT $3,675 1.59 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- . $14.50 STRUCTIO R TH AN�OCO�STRUCTION. PLAN CHECK FEE TOTALFEE GNaau FCO CTORORAUTHORIZEDAGENT (DATE) LY VALIDAT D TH I YOUR PERMIT r.f '-.- 07z:�:— BLDG. (NSP DATE SIGNATURE OF OWNER (IF OW ER BUILDER) (DATE) APPLICATION FOR RLSIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF I-RILILLY, MINNESOTA OWNER'S NAME:]o aqR.S2a Cry eP BUILDER: /_�?A y [ , D_ 1mR,0qC 7D1Qj ADDRESS: Ly L YZ_e,- , Z4f .��Aed,: ADDRESS • 2L? Z– Qalel–myd //U,-- NO p . --- T STREET: TOOT; L BLOCK: ADDITION: (,/�5�–/ le CORNER LOT; INSIDE LOT: 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: gFront: j�4,-O �""j, CIT Depth: Height: Square Feet: Cubic Feet: 00 Front: Depth: Height:_ Square Feet; Cubic Feet: -- Type of Construction:Estimated Cost: To Be Completed: -/Zw la 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 A declares that ill the facts and representations stated in this application are true and corrt-ct. DATE: /.2— � - _ SIGNATUt (See Reverse Side For Additional Information.) e City of Fridley suedEcr PERMIT NO. 124 AT THE TOP OF THE TWINS BUILDING PERMIT r PT NO EI `L ____ 1 COMMUNITY DEVELOPMENT DIV. �®� r � PROTECTIVE INSPECTION SEC. ; I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L•"'� � ,'J 612-580-3450 910415 4,111,174 JOB ADDRESS 111*1 1 LEGAL LOT NO. C O JCDDITION SEE ATTACHED DESCR. l 7 Christie Addit-inn SHEET 2 PROPERTYOWNE MAIL ADDRESS ZIP PHONE Ronald L. Brogger 6341 Monroe Street WE. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same --Z-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 EX NEW X ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 00.9 Construct a 18' x 241 Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 432 4,320 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 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, $2,289 1.14 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $8.00 PLAN CHECK FEE TOTAL FEE 9.14 '-871-NATURE OF CONT?RCTOR OR AUTHOR GENT (DATE) WHEN PROP [�-BM INSP RLY ALI ED IS IS YOUR PERMIT GATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) APPLICATION FOR RLSIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CI'T'Y OF I -PI DLLY, MINNESOTA OWNER. I S NAME :�'CO LGGG« BUILDER: ADDRESS : lO =tZ'O/r/e®�-;7 s% AE ADDRESS: NO;. &3L% --STREET BLOCK: 7 ADDITION: CORNER LOT: INSIDE LOT:�_SETBACK: SIDEYAFD: Applicant attach to this form Two Certificates of Survey of Lot and proposed buildizig location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: CAR&6,!F jW Front: "r Depth: a5�eG Height: 91 Square Feet:_�Y3Z- Cubic Feet: 3,e/-6 Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Awe Estimated Cost: To. Be Completed: 11?7z The undersigned hereby makes application for a permit for the work herein, specified, agreeing to do all work in st7tict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that -i11 the facts and representations stated in this application are true and .jrr.-ct. (See Reverse Side For S I C; NATi! Additional Information.) I, _Nf{yN E R. W W t TE ry i L - owner of the property located at G3:51 i-NorJG ST, 16 jPhave no objection to the City allowing the construction of a to be located at zu without the required certificate of survey that the City ordinarily requires for arl/l/ new construction. 4 t Signe Address Drake s n mn.*-mI ST. 634% s 01 SUBJECT 0. City of Fridley 30070 AT THE TOP OF THE TWINS BUILDING PERMIT r ATCVT NO. ------ COMMUNITY DEVELOPMENT DIV. SEC. � ^ O r I PROTECTIVE INSPECTION 1 . � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED Br 612-571-3450 910415 8/17/99 JOB ADDRESS 6341 Monroe Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DES CR. 14 7 1 Christie Addition SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Suzanne Sater 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 x® ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 301 x 201 Deck 9 CHANGEOFUSEFROM TO STIPULATIONS See stipulations on plan Before digging call for all utility locations 434-0002 REQUIRED BY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 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 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 1700 $2.00 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 $97.25 Fire SC S4.00 PLAN CHECK FEE TOTALF SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE. EN P OPERWj#LIDATED IS YDhLR PER T BLD INSP nAtE S-GNATU RE OF OWNER IF OWNER BUILDER. IDATEI 01 NEW W # Effective 5/10/99 ADDN CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 6 `3 41 _M ® � ro � 5 k. rr rJt It,5z(3 �- Legal Description: u,zarl�� r' Owner Name & Address: L�3 Ll / Mo r ro r S Tel. # Contractor:_ -F 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. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length "3® Width 'pL® Hgt/Ground �6" Sq. Ft. Ll -�o OTHER: Construction Type:_ G r", firs, �J Decile Estimated Cost: $ / _ —700,0-r' Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 4 APPLICANT: S v, z,~ c— 5k".-- Tel. # S 11 — 0 S'S Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] SUBJECT City of Fridley 3 g 9 g AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r v PROTECTIVE INSPECTION SEC. 572-30 '549V NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 6/12/01 JOB ADDRESS 6341 Monroe Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 7 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Suzanne Sater 6341 Monroe Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Steve Knutson 763-571-6959 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION fKl REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Soffit & Fascia 9 CHANGEOFUSEFROM TO STIPULATIONS Install soffit ventilation to meet the State Building Code. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 OWLG- UNITS OFFSTREET PARKING I 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $300 $•50 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- $23.50 Fire SC $.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE 24.50 SIGN TORE OF CON"RAGTO R AUT RIZED AGENT IDATE� HWE TE THISZSOUR P MIT �VALIO �S.GNATURE OF OwNER.,F ER BUS ERS SOA E� B MATE 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: 6 3 L(I Legal Description: / Owner Name & Address: � c, zannt ��z � ��y 1 Mo n�o� Tel. # Contractor. Iy lk MN LICENSE # Address: Tel. # LIVING AREA: GARAGE AREA: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: S C � o. Construction Type: r V� erg So'�'��" Estimated Cost: $ pp 00 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 6 6 ! APPLICANT: -� -c .�-L l�C s� �.. i -S o n Tel. #76 3 S-7/49 Si CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1150 per SAC Unit License Surcharge $ i $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 $ �r� STIPULATIONS: l 01 SUBJECT 0, City of Fridley Th'934 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r E PROTECTIVE INSPECTION SEC. d -o C,J�� NUMBERDATE nEv PAGE OF APPROVED By i ��"'f;•� CITY HALL FRIDLEY 55432 ----� L 763-571-3450 910-F 15 10 / 1/03 JOB ADDRESS 6341 Monroe Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 7 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Suzanne Sater 6341 Monroe Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Northwest Exteriors Inc 6500 Walker St St Louis Park MN 55426 952-926-8663 a 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 j] REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Replace windows within existing openings 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 I 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 WH THER SPECIFIED EIN OR NOT THE GRANTING OF A PERMIT $8,250 $4.12 DOES T PRESUME TO IV AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVI ION OF ANY ,KTERMSTATEE OR LOCAL LAW REGULATING CON- STRU TIO OR THE ANCOF CONSTRUCTION $167.25 Fi SC $8.25 PLAN CHECK FEE TOT L FEE Lice $5.0 184.62 IG TUBE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI EN ROP VALID D THIS IS YOUR PERMIT -,DATE, S-GNATURE OF OVVNERIF OWNER BUILDERI Bl IN 7 FlATE l 01 F®-04-2002 10:25 FROM CITY OF FRIDLEY TO 9529265960 P.Ul/02 NEW (]. CITY OF FRIDLEY Eftiaclive 1/12002 ADDN [ ] 6431 Univemity AVG NE, Fridley, MN 88432 (763) 8724604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ��,34'1-1 BUILDING PERMIT APPLICATION Construction Address / /�_ � , P4&mzx' ��T Legal Description Owner Name & Address: Contractor. WING AREA: GARAGE AREA: DECK AREA: IJL S r')(!- Tel. # MN LICENSE# q Z- It Z4, - %GG 3 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on It to scale. DESCRIPTION OF IMPROVEMENT Length width _ Height Sq. Ft Length Width w Height Sq. Ft Length Width Hgt/Ground Sq. Ft OTHER Construction kt-'- --cft°00Estimated Cost $ Driveway Curb Cut Width Needed: Ft8 t Ft A. 6 a !��/-�✓�� �H - Tei. DATE. APPLICANT• Cali (763) 572.3604 for Permit Fees If mailing In application or Fax to 7"71.1287 H using credit card and we will call you for card, number, Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Pee Sewer Main Charge CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50V$1,000 Valuation $1200 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 [ j Not Necessary j TOTAL $ r 40 �' SSTIPULATION&