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PRE 2010 DOCSBUILDING PERMIT Village of Fridley, Minn. Date ' i, ............................. Owner Address .....:'. 2148 Builder....................1i...................... Address.................. ...................... LOCATION OF BUILDING NoALI0....... Street . � � ....................... Part of Lot Lot ........' Block ...10.......... Addition or Sub -Division ................, Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ... l. l ..................... DESCRIPTION OF BUILDING To he Used as: s 0 - Front - A . ..IM�"Depth A41r. Height Front ........ Depth ........ Height ......... Type of Construction.�14,r lt.,%4 '... Est. Cost .1,7.0.60—#49 ..... Sq. Ft. ...11. .... Cu. Ft......... Sq. Ft... ... Cu. Ft......... To be Comple ed In consideration of the issuance to me of a permit to construct the building the proposed work in accordance with the description abovg set forth and in co ordinances of the village of Fridley. !d above, I agree to do with all provisions of . ....................... In consideration of the payment of a fee of $..IRj. , permit is hereby granted to ,f;„( �►.. � ..... to construct the building or addition as described above. permit is granted upon the express condition that the person to whom it is granted and his agents, employees d workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all resp s to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and oving of buildings with- in the village -limits and this permit may be revoked at any time upon violation of any f the provisions of said ordinances. // Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, lumbing, gas heating, sewer or water. Be sure to see. the Building Inspector for separate permits for these Items. �q� City of Fridley, Minn. BUILDING PERMIT N® 7469 Date: Z., 1965 T*iner: Mot xccA3&Z Builder Blanahe Const. Co. _Addresh3fiQ Monroe Address 108 Pattgm Rd, KW Briffliton LOCATION OF BUILDING No. 635Q KQWWAet _ Part of Lot Lot _. ___ _ Block 6 Addition or Sub -Division ._brJ stie Corner Lot Inside Lot _ _ Setback — Sideyard Sewer Elevation To be Used as: Foundation Elevation DESCRIPTION OF BUILDING Front Depth Height . _ Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. Cost 4p800 To be Completed Repair storm damage 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 a'll provisions of ordinano� oP the city of Fridley. (SZ4 � b,�s��'e%li��c In consideration of the payment of a fee of $10. 0 , permit is hereby granted to the COnStr'l1Cti0II Com to construct the building or addition as described above. This permit is granted upon the express oondition that the person to whom it is granted and his agents, employees and workmen, in all work done h►, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota reg ng location, construct�fon, alteration, maintenance, repair and moving of buildings within the dty ]units and this permit may be revoked at aqy time upon violation of any of the provisions of said ordinances. NOTICE: This permit don not corer the candruction, installation for wiring, Plumbing, an heating, sewer or water. Be sen to see tiro Building Inspector for separate permits for thea hems. APPLICATION FOR B ING PERMIT CITY OF FRIDLEYO NMSOTA OWNER' S NAME BUILDER ADDRESS �;�� �� ����%��I.GrZ-e.i`� ADDRESS le9r- ,�����ell LOCATION OF BING No. Stteet. Part of Lot. . Lot � Block �� Addition or Subdivi5sign Corner Lot Inside Lot etV4tk Sidi Yard SEWER ELEVATION FOUNDATION EUVATION Applicant attach to thia form, Two Certificates of. Survey of Lot -and proposed build- ing location driva on these Cartificates. To be used as; DESCRIPTION OF BUILDING 'roaC Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sze. Ft. Cu. Ft. Type of Construction_ ,t�" Estimated Coaa --To-.be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing'to do all work im strict accordance with the City of Fridley Ordinances and rulings of the Department' of Buildings, and hereby declares that all the fsacts and representations stated in this application are true and correct. -tSchedule of Fee Costs can be found on the Reverse Side). A 1 CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 1998 q 6431 University Ave NE Vv Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 1,Q�) 50 M b VVbf kke RATE SCHEDULE Residential Fumace Shell and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer The undersigned hereby makes application for a permit for the work herein .--- Rate 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 $ 30.00 $_Eikb representations stated in this application are true and correct. -��- 99 , $10.00 $ OWNER �,N r rf Cl -0"V- � V $10.00 $ $10.00 $ *Air Conditioning All Sizes $ 25.00 ­G�a"Wf V3LO3KOON All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or.Work Commercial/Industrial 1.25° of Value of Appliance or Work State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOUNG/VENTILATION 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. BUILDING USED AS d w-tW V-\ q ESTIMATED COST raj 0-0 • 0-0 PERMIT NO. 136S DESCRIPTION OF FURNACE AND OR BURNER No.' of Heating Units I Circle One (Steam) (Hot Water) arm r) Trade Name . e oy t Size No. �ETCH V b _ C) 0-10 BTU QLD 10-" HP EDR Fuel t\j rj, G( -1) Total Connected Load Burner Trade Name Size No. BTU HP EDR Approved Byd FILL OUT BACK SIDE FOR ST REPLACEMENT FURNACE BLAINE 14TG. A;�C ELECT., INC 13M CENTRAL AVE. N.E. ANOKA MN REAM du Tel No. -i - ( o'� Rough—in Date Final Date A-0) VERIFICATION ON CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been ,carefully examined Yes (J � No ( ) 2. Is free from rust or deterioration Yes No ( ) 3. Has no foreign objects lodged within Yes (�) No ( ) 4. Is° securely supported YesN No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes ()4 No ( ) 6 Has total heating BTU's of 1MY0 All other BTU's -V ®, TOTAL BTU's Dau 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: ULAINE HTG. A,C ELECT., INC. 13562 CENTRAL AVE. N.E. 4 C17YOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287 August 9, 2000 Shirley McCarty 6350 Monroe St NE Fridley, MN 55432 Re: Final Reinspection at 6350 Monroe St NE Contractor: Blaine Htg. A/C Elect., Inc Dear Ms. McCarty: A mechanical permit was issued on May 12, 2000 for the property located at 6350 Monroe St NE for a furnace and an air conditioning unit. According to Section 305(a) of the 1991 Uniform Mechanical Code a final inspection shall be performed on the mechanical system. An inspection was conducted on 6-3-99, which noted the following corrections: 1) Provide a one -inch clearance from combustibles through wall and floor. 2) Firestop around chimney at first floor level. Please call for a final inspection on these corrections within 30 days of receiving this letter. We will expire the permit if we do not hear from you and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (763) 572-3603. Sincerely, DAVNSEN Buil g Inspector OCCUPANT, HEAT LOSS, SOLD BY_ Electrical Work By Zta /%liha TYPE OF HEAT GA__ FA ®L HEATING AIR CONDITIONING AND ELECTRIC, INC. 1-0 HOUSE HEATING TEST RECORD APT. P FLOOR CITY SUBURB OWNER IVA INSTALLED BY A&A, Gem Line By SPACE HTR. UNIT HTR. OTHER CONTROLS THERMOSTAT '7 epi, A Heat Plug Limit Fan! Pilot Pilot Pilot L.W. Cut Off Pressurev Percent CO2 0 Input CFH Percent 02 d b Stack Temp. �J�r� Percent CONVERSION Vent Size "i' KIND OF LINER SIZE NONE Draft Hood Regulator (O Filters Size /& X Z.S' X 3 Number / Chimney Location Inside x Outside Chimney Construction &5S Smoke Bomb � � r Draft Test T �.E. Door Pressure Lighting Inst. xe=5 Date Tested — �- Company Testing CONTROLS THERMOSTAT '7 epi, A Heat Plug Limit Fan! Pilot Pilot Pilot L.W. Cut Off Pressurev Percent CO2 0 Input CFH Percent 02 d b Stack Temp. �J�r� Percent CONVERSION Vent Size "i' KIND OF LINER SIZE NONE Draft Hood Regulator (O Filters Size /& X Z.S' X 3 Number / Chimney Location Inside x Outside Chimney Construction &5S Smoke Bomb Wiring Ve Draft Test T �.E. Door Pressure Lighting Inst. xe=5 Date Tested — �- Company Testing Name of Tester Pressure Percent CO2 Input CFH Percent 02 Stack Temp. Percent CO 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 UIV. APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas`* Gas Range'"* Gas Dryer`* Back Flow Preventer Required ( )Yes () Nc Type NO. RATE TOTAL $7.00 21,06 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge .50 TOTAL FEE $-122- JOB JOB ADDRESS 635-0' 172on rn e- S� 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 Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. Ownerr-1 o_ /yo—��-� 741 %/ Building Used Estimated Cost /3CO. 00 PERMIT NO.__ / 3 LIZ PLUMBING COMPANY r PL, SIGNED BY 7 A' TEL N0. 612-,Zo21— 37/9 FAX # Approved By Rough -In Date Final Date2C__� COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VFNT V NT CONKECTOR AND COMMIRTION AIR VFRIFICATION When replar,.inn an existing ftirane-P, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes No ( ) The venting system is plasbc/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes( ) No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) The Pxichnn cnmh ,stinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to anctall a new cnmhnstinn air, it will be sized and installed to meet the current codes and manufacturers specifications. Yes( ) No( ) When jpgtajlann a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers spe ficabons. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No-( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appleance Zype and -q17P/Cnmmnn Vent and Vent Cnnnactor Informatinn Appliance #1 Type --Appriance #2 Type Appliance #3 Type BTU Input BTU Input BTU Input Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat i otal Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height Appliance #2 Vent Connector Height Appliance #3 Vent Connector Height oI TFRATIONS- (DPs�hP) ft Length ft Length ft Length ft Diameter in Type ft Diameter in Type ft Diameter in Type M HEATING CO: Signed By: Date: SuB.,ECT City of Fridley dPE AT THE TOP OF THE TWINS BUILDING PERMIT r ` RECEIPT NO. `v ______ COMMUNITY DEVELOPMENT DIV. l PROTECTIVE INSPECTION SEC. i NUMBER 11Ev DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 L 612-571-3450 910415 4/29/02 JOB ADDRESS 6350 Monroe Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 6 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Shirley McCarty 6350 Monroe Street NE 763-571-3057 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Window Lite Home Improvments 8400 89 Ave N STE 460, Brooklyn Park, MN 55445 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 763-425-2227 20039258 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION 0. ALTERATION ❑ REPAIR ❑ MOVE - ❑ REMOVE 8 DESCRIBE WORK Bathroom Remodel 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. 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. 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 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 $ 10,472 $5.24 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 PAOV S OF ANY OTHE STATE OR LOCAL LAW REGULATING CON. $195.25 Fire SC $10.47 ST CTIO OR THE P OMMAE OF CONSTRUCTION PLAN F TO AL FEE 94CHECK JAI &6MoZ� Lice e C $5. 215.96 4JTHORIZEOAGENT 10ATE EN PROP Y VALIOA D THIS IS R PERMIT �IGNATUOFOWIZACTWAOR Bl -NSF' � 2s r)A 1E S-GNATURE OF OWNEA,1F OWNER BUILDER] 1DATE. ,NERi [ ] �-`� 1 ���� Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ' BUILDING PERMIT APPLICATION Construction T e: E)d c fflvjqj& Estimated Cost: $ /G, LI -7a - (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: a 5 G' APPLICANT: vYv� Tel. ?( �3cl� 83%O Permit Fee .Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge TOTAL STIPULATIONS: a 160 ?& 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 [ ] ConstructionAddress: �2., r� - /` a 5 -q&, 2:, f " - Legal Description: Owner Name &Address: �" <5Kl' � e� �� Tel. #(71,5-) 57 1- � 36 -7 Contractor: Z'!� Lie (cam d2t" " _ MN LICENSE # oZ? .V a 5,f Address: Jh 4- pp 94M a4 ri m k) , (W -i rn i0hJ A/0 Tel. #�7�v3� 61,;5 -teal Attach to this application, a Certificate of Survey of the P'C� nk4 Li� �%/aYr7 lot, with the proposed construction drawn on it to scale. (7 3 9310 DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: "t Length Width Hgt/Ground Sq. Ft. OTHER: Construction T e: E)d c fflvjqj& Estimated Cost: $ /G, LI -7a - (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: a 5 G' APPLICANT: vYv� Tel. ?( �3cl� 83%O Permit Fee .Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge TOTAL STIPULATIONS: a 160 ?& 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 $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] u SUBJE& PE City of Fridley 3 71974 7 AT THE TOP OF THE TWINS BUILDING PERMIT r? ' RECEIPT NO. COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC. 2-36®4 572-3604 -79 r i ��"'t;•� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY -__.� L 612-571-3450 910415 6/29/01 JOB ADDRESS 6350 Monroe Street NE 1 LEGAL LOT N0, BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 6 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Shirley McCarthy 6350 Monroe Street NE 571-3057 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Window Lite Home Imp. 8400 89 Ave N, Brooklyn Park, MN 55445 425-2227 20039258 4 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 ❑ ADDITION ❑ ALTERATION 0. REPAIR ❑ MOVE - ❑ REMOVE B DESCRIBE WORK Replace 13 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 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 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 $12,829 @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT `1 '6.42 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISI ANY OTHER STATE OR LOCAL LAW REGULATING CON- $223.25 Fire SC X12.83 S ION THE PERFO CONSTRUCTION OR ^2- -ol PLAN CHECK FEE Li se C $5.00 TOTAL FEE $247.50 SIGNATURE OF CON' ACTOR OA AUTMORIZEO AGENT IDATEI ,. H PROPERLY VALIDATED THIS IS YOU PERM IT/ S,GNA TU RE OF OW NERi6 OWNER BU40ERI IDATE- BL G P u D�/%� NEW S ENT"D MAY 312001 [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress : Legal Description: Owner Name & Address: Contractor: `n Address: 94z— YqV ci k-! M Tel.# J %/—J3 ,, � MN LICENSE # a,9D ��,� 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: Construction Type: ` Estimated Cost: $ Z& (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APPLICANT:(-- CITY USE ONLY Tel. #�Z5 J9/?-3KK Permit Fee $ &03, Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $c.I , OrD $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: