PRE 2010 DOCSCity of Fridley
SUBJECT
''P O.
r 16978
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
COMMUNITY DEVELOPMENT. DIV.
RE
��-
r 1 PROTECTIVE INSPECTION SEC.
�
S
�r���CITY HALL FRIDLEY 55432
i
L ,,j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
---•�
612-571-3450
910-F15
14/13-83
JOB 1AW Riverview Terrace N.E.
1 LEGAL
LOT NO.
3-26
BLOCK
U
TRACT OR ADDITION SEE ATTACHED
Riverview Heights SHEET
DESCR.
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Allan Stahlberg 305 89th Avenue N,E, 786-1355
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
Ek NEW ❑ ADDITION ❑ ALTERATION ❑ EPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct new home 40 x 32 and garage 20 x 24
9 CHANGE OF USE FROM TO
STIPULATIONS
1. Minimum basement (lower floor) 824.6
2. Elevation or gradel5' out from structure 822.6
3. Special Use Permit approved by City Council 3-22-82
i
SEPERATE PERMITS REQUIRE® FOR W1IRINA
HEATING, P.IUMBIMG AND, SIGn
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANC`(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
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
q
49,700
24.85
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-
283.00
425.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
5
I A 803.60
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI.
VH PROP L LI E HIS IS YOUR PERMISIGNATURE
�t�BLDC_INSP
�A7E
OF OWNER IIF OWNER BUILDERI IDATEI
CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATIC14 FOR RESIDENTIAL BUILDING PEW4ITS
(NEw, Alterations, Additions. or Repairs)
OWNER: _ /��` /I/ �� i���i ����� BUI LDER:
ADDRESS: ,®� ��'��' ADDRESS:
TEL NO: " 7 T6 3 TEL NO:
Construction Location
STRIST NO: ® STREET:
-...`.
IAT: BLOCK: - ADDITION:
Corner Lot: � Insiae Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOR OF CONSTRUCTION
F : 0 C- Front: 40 Depth: QHeight: c� (�
Square Feet: Cubic Feet:
Front: �( Depth: Height: Ly
Square Feet: Cubic Feet:
Type of Corztruction: UP-4ft � , T
Estimated Costa 5 1:7®�
2b Be Osripleted:
Alt. A Alt. B
]Proposed Driveway Width If New Opening Is Desired: S S
SEE REVERSE SIDE. OF SHEET
Tire undersigned hereby makes application for a permit for the work herein specified,
agreeing to do,all work in strict accordance with the City of Fridley Ordinances and
rulings of the Delkzrtment of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct.
D.ZTEs �� R SIGNATURE:
Stipulati ns:
'x
r
G '#'Wr &Swro'a F
JE�'� 61L l,�ftrrA
f �� •
a l dof
r-,4 X22.6
ISNTCA I" U Ste.
APAItOuR,.a
' EXTERIOR ENVELOPE THEMAL TRANSMITTANCE PAGE 1
STANDARD WORKSHEET
Site Address e ;—;tee l.i.1 6
- Owner
Contractor Phone Date - (-
Building Type (check one) One and Two Family Dwelling Other
Assembly (Describe type from Table 3 or Area (Aj U®Value U x A
show calculations onPae 2 S Ft
Insulated Area ®zd_'- . 67-S7 zz„s'b
Framing Area!P 0 ./1.5 . 6Zy�
0
Sk li hts Type
4 Totals
a
5 Average U -Value, UxA / A from Line 4
6 1 Required U•Value from text
,P
Other describe
v
Other describe
--fallowing
to determire alternative U -Value for
total exterior enveloce.
7 Area (Line 1) + Area (Line 4), +
1 Total s
®
�" `***
7-
87 UxA (Line 1) + UxA(Line 4), +
2 Avera a U -Value UxA / A from Line 1
******
OHO
******
a
3 Required U -Value from text
a,
=
10 Area (Line 4) x U -Value (Line 6). x
******
w
11
Insulated Area
0
Alternative U -Value, Line 11/Line 7
Framing Area m
O
• ® 8
%d . %
6JA ,C�e b
Line 8 is greater than Line 11, all-er assemblies as required so Line 8
not Weea Line 11.
Windows, T e
120-4
✓O
tSS
13
Doors T e /�i ` ,N
Rim Joist Area
r-
__Fireplace Wall
q
m
Foundation Wall above rade
0
Foundation Windows, T e
Other describe '
4 Totals
5 Average U -Value, UxA / A from Line 4
6 1 Required U•Value from text
If Line 2 is greater than Line 3, or Line 5 greater than Line 6, complete tha
--fallowing
to determire alternative U -Value for
total exterior enveloce.
7 Area (Line 1) + Area (Line 4), +
c
a�
87 UxA (Line 1) + UxA(Line 4), +
®
9 Area (Line 1) x U -Value.'(, ine 3) x
a
******
a,
=
10 Area (Line 4) x U -Value (Line 6). x
******
w
11
"Budget". Line 9 + Line 10
0
Alternative U -Value, Line 11/Line 7
12
Line 8 is greater than Line 11, all-er assemblies as required so Line 8
not Weea Line 11.
If
does
EXTERIOR ENVELOPE STANDARD WORKSHEET;
error r -Value see Table 2
error f-Vaiue see Tabla 2
al Asser„blv Thermal Resistance Zs'.,
Prihi v ll—VAl itsa tcoo TaF,I a A_
nzerior f®Value (see Table 2)
x_terior f -.Value see Table 2)
oral Assembl v Thernnal Resi stanc
ceAathlva [I—Valaa® cn® T,hln t
ar.erlor f -:aloe (see Taole 2
3 E'x:erior° f-�falue (see Table 2
LTC -1 Thermal Rrs i s;.
Po' aesroly U -value (sea lduie 4
PAG 2
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
RATE SCHEDULE
PLUMBING FIXTURE RATES:
New Fixtures -
Future Fixtures
Old Opening, New Fixture
Beer Dispenser
Hlow Off Basin
Catch Basin
Rain Water Leader
Hydraulic Valve
Sump or Receiving Tank
Water Treating Appliance
Hot Water Heater
Gas Range
Gas Dryer
NO. RATE TOTAL
S 5.00' $
$ 3.50 $
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1% of Value of Fixture or Appliance
$ 1.50
$ 4.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 7.00
$ 5.00
$ 10.00
$ 10.00_
Reinspection Fee $ State Surcharge
(515.00) TOTAL FEE
Effective Aug. 10 1981
Job Address 925-5— R1 61, Lew Li2u
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.
OWNER
KIND OF BUILDING �7� (/ S G-=
lC
USED AS _ _ G 5' 0/C-
TO BE COMPLETED ABOUT
ESTIMATED COST5�,
OLD
NEW BU LDING PERMIT NO. PERMIT NO. 19!68
i
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
>,
m
es
U
v
Water
aei
49
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E
.9: 4
[7
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to ►�
W
�"
5
Heater
M
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1
+4 1
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to
3
Q W
CCA
W
Amy
U
��no
lst
_
f
►
2nd
1
//1
1
3rd
4th
(R) - Future Connection Opening
Connected with Sewer
(*) . New Fixture, Old Opening
Water
RATE SCHEDULE
PLUMBING FIXTURE RATES:
New Fixtures -
Future Fixtures
Old Opening, New Fixture
Beer Dispenser
Hlow Off Basin
Catch Basin
Rain Water Leader
Hydraulic Valve
Sump or Receiving Tank
Water Treating Appliance
Hot Water Heater
Gas Range
Gas Dryer
NO. RATE TOTAL
S 5.00' $
$ 3.50 $
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1% of Value of Fixture or Appliance
$ 1.50
$ 4.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 5.00
$ 7.00
$ 5.00
$ 10.00
$ 10.00_
Reinspection Fee $ State Surcharge
(515.00) TOTAL FEE
Effective Aug. 10 1981
Job Address 925-5— R1 61, Lew Li2u
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.
OWNER
KIND OF BUILDING �7� (/ S G-=
lC
USED AS _ _ G 5' 0/C-
TO BE COMPLETED ABOUT
ESTIMATED COST5�,
OLD
NEW BU LDING PERMIT NO. PERMIT NO. 19!68
i
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 Company
PLUS $.50 STATE SURCHARGE
Signed By
Attach stack verification form with replacement furnace peamita 719 /
Tel. No.
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
3
Effective Aug. 1, 1981
CITY OF
FRIDLEY
APPLICATION FOR POWER
PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
AIR
CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL
RATE
TOTAL
�/
Job Address ® i L l/L i (' lily F---w /v C
Furnace Shell and Duct Work,
Burner (Also replacement furnace) $
20.00
$20,
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
City of Fridley
Gas Piping $
10.00
$ to
Tel. 0571-3450
(piping needed with new furnace)
Gas Range $
10.00
$ 4
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
Gas Dryer $
10.00
$ / ®
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
• Air Conditioning (all sizes) $
10.00
$*
Fridley, Minn.
f
1/9etl 7oZ� t
All Others/Repairs and Alterations
OWNER / y/ e
li of Value of Appliance or Work
$
KIND OF BUILDING
COMMERCIAL/INDUSTRIAL
e
USED AS
10 of Value of Appliance or Work
$
TO BE COMPLETED ABOUT JI-0 F
ESTIMATED COST� Q C)
State Surcharge
$ .50
�
OLD - NEW BUILDING PERMIT NO. PERMIT NO. ,rs 3"j
TOTAL. FEE
$ 5--0'
Reinspection Fee ($15.00)
$
DESCRIPTION OF FURNACE/BURNER
Rough Insp.
Date
HEATING or POWER PLANTS, Steam, Hot Water, sa Ai No.
G SewSise No. ��,, ®" FL)
Final Insp. �- —k4l
Trade Name l
Date
Capacity Sq. Ft. EDR BTU &46100 HP
Approval for Permit /9
Total Connected Load Kind of Fuel
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 Company
PLUS $.50 STATE SURCHARGE
Signed By
Attach stack verification form with replacement furnace peamita 719 /
Tel. No.
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
3
CITY OF FRIDL.EY
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
TELEPHONE ( 612)571-3450
February 17, 1984
Mr. Allan Stahlberg
8055 Riverview Terrace N.E.
Fridley, MN 55432
Re: Final Inspection at 8055 Riverview Terrace N.E.
Dear Mr. Stahlberg:
A final inspection was conducted on February 16, 1984 of the above
address and the following items were noted which must be completed
before the structure can be finaled out:
1. Provide City with copy of verifying survey of lot.
2. Call our Engineering Department for an approval on the final
grade before sodding.
3. Provide sod in the front and side yards.
4. Post address on structure.
5. Change at least one lock from double cylinder to single
cylinder.
We will expect items 1, 2 and 3 to be completed by June 1, 1984 and
items 4 and 5 to be completed by March 1, 1984 when reinspections
will be made to determine compliance.
If you have any questions on these items, please feel free to
contact me at 571-3450.
Sincerely,
DARREL G. CLARK
Chief Building Inspector
DGC/mh
0
F'RIDOF
LEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E., FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
June 6, 1984
Mr. Allan Stahlberg
8055 Riverview Terrace N.E.
Fridley, MN 55432
He: Final Inspection at 8055 Riverview Terrace N.E. (SECOND NOTICE)
Dear Mr. Stahlberg:
A reinspection was conducted on June 4, 1984 of the above noted address to
determine compliance with our letter to you dated February 17, 1984. This
inspection determined that the following items have still not been completed:
1. Provide the City with a copy of a verifying survey of the lot.
2. Provide sod in the front and side yards. Contact the City Engineering
Department for an approval of the final grade before sodding.
3. Post address on structure.
We will expect the above items to be completed by July 2, 1984 when a
reinspection will be made to determine compliance. If you have any questions
on these items, please feel free to contact me at 571-3450.
Sincerely,
DARREL G. CLARK
Chief Building Official
DGC/mh
0
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E., FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
July 51 1984
Mr. Allan Stahlberg
8055 Riverview Terrace N.E.
Fridley, MN 55432
Re: Final Inspection at 8055 Riverview Terrace N.E. (THIRD NOTICE)
Dear Mr. Stahlberg:
Reinspec tions were conducted on June 4, 1984 and July 2, 1984 of the above
noted address to determine compliance with our letter to you dated February
17, 1984. This reinspection has again determined that the following items
have still not been completed:
I. Provide the City with a copy of a verifying survey of the lot.
2. Provide sod in the front and side yards. Contact the City Engineering
Department for an approval of the final grade before sodding.
We will expect the above items to be completed by August 1, 1984 when a
reinspection will again be made to determine compliance. If you have any
questions on these items, please feel free to contact me at 571-3450.
Failure to complete these items may result in this matter being turned over
to the City Prosecutor for his legal consideration.
Sincerely,
CLARK
Chief Building Official
DGC/mh
June 2, 1986
First Capital Mortgage
240 opus Gateway
9800 Bren Road East
Minnetonka, MLQ 55343
Dear Mr. Keven Henslin:
Please find the flood insurance form you requested to have filled out
enclosed. Please note that the City of Fridley has only the authority to
acknowledge that the said property, 8055 Riverview Terrace is located in Zone
A-12 of the Mississippi River designated 100 year flood zone hazard area.
The City is not authorized to determine whether or not a residence requires
flood insurance, that is the responsibility of the mortgage company sponsoring
the loan.
I have enclosed the post construction elevation certif icate/floodproof ing
certificate for this property from 1984.
There is a toll free number the Federal Emergency Mortgage Agency (FEMA) gave
us for additional information (1-800-638-6620).
Sincerely,
Darrel ark, OOAA�
Chief Building Inspector
Enclosures
First Capital Mortgage
2400
40 Opus
Gateway
9800 Bren Road East
Minnetonka, Minnesota 55343
A division of Rist Capital Resources Corporation
(612) 933-7725
5/27/86
Dear Mr. Clark:
Mr. Stahlberg is seeking financing through us.
He has informed us that his house is in a flood
area but it is high enough where flood insurance
is not required. Please fill out this form and
return to us, explaining Mr. Stahlberg's situation.
Thank you,
Keven Henslin
Loan Officer
CERTIFICATION RE: FWD INSURANCE
IA= No. :�90-1166S
Name of Borrower: Allan B. Stahlberg
Property Address: 8055 River View Terrace N.E., Fridley, Mn 55432
this is to certify that has
examined maps of flood hazard areas designated by the Department of H3using
and Urban Development, Federal Insurance Administration, and determin3d the
following information:
(A) Subject property
is
located in a designated flood hazard area
(� is not
(B) Flood hazard insurance
.. � is
available
is not
(C) Flood hazard insurance
is
required
(� is not
%_ v
Date
r
G7YOF
FRIDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55431 • PHONE (612) 571-3450
March 10, 1989
Al Stahlberg
8055 Riverview Terrace N.E.
Fridley, MN 55432
Dear Mr. Stahlberg:
This is to confirm that the City of Fridley has determined that the
elevation of the threshold of the front door of your home at 8055
Riverview Terrace is at 824.40 feet. The floodplain elevation in
this area is at 823.8 feet.
It is my understanding that your mortgage company requested
verification of this matter. Please feel free to contact me if you
need further information.
Sincerely,
Barbara Dacy
Planning Coordinator
BD/dn
C-89-105
,7
CITYOF
FRIDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E.. FRIDLEY. MINNESOTA 55432 • PHONE (612) 571-3450
July 10, 1986 PW86-114
Kevin Henslin
First Capital Mortgage Company
3300 County Road 10
Suite 412
Brooklyn Center, MN 55429
Dear Mr. Henslin:
We have determined thattheelevation of the threshold of the
front door of 8055 Riverview Terrace, Fridley, Minnesota, is
at 824.40 feet. The flood plain elevation in this area is at
823.8 feet.
If you require more information on this site, please call me
at 571-3450, ext. 158.
Sincerely, /
Mark L. Burch
Assistant Director of Public Works
MLB/ts
cc: Al Stah7berg, 8055 Riverview Terrace, Fridley, M
Building
$ ° 93A V
BUILDING
Permit No.: d001LI
Inspections
65% of Building Permit Fee
RESIDENTIAL APPLICATION
Received By:
763-572-3604
Surcharge
CITY OF FRIDLEY
DatRRTd.
763-502-4977 FAX
$ .
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1825 per SAC Unit (Plans to MWCC for determination)
EFFECTIVE 1-I-08
$
DATE - �.49
YOUR E-MAIL ADDRESS 16 Q C tot % Q
-J—
SITE ADDRESS 80 55 9,4'�C /' V e e..-0.mom-'°
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
Agreement necessary ( ) Non Necessary ( )
PROPERTY OWNER/
NAME: Co
Make checks payable to: City of Fridley Attach Stipulations
ADDRESS:80,15'-i- e ,L" V%U"1 B��` Y � �°°`/
STATFo�SLIP
TENANT
PHONE: -7b 0 - 74r, '-' l Tfs-
NAME: $
ADDRESS: /'i 5,* /f l rJ CITY T I -t STATE ZIP S° V 9
CONTRACTOR
SUBMIT A COPY OF
PHONE (I d 5'l��v' FAX
YOUR STATE LICENSE
STATE LICENSE # C40 4gR`%,4 % EXP DATE
J?
PROPERTY TYPE
XSINGLE FAMILYNEW CONSTRUCTION SIZE
TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ G GE/SHED ❑ WINDOWS
❑ BASEMENT FINISH a1OOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION 0,ADDITION
❑ MAINTENANCE/REPAIR REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING ❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
1.
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used,
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
ADDITIONS. & PORCHES SUBMIT:
❑ Vinyl
❑Soffit
1.
Site Plan/Survey showing the existing structures
❑ Aluminum
❑ Trim
and proposed project.
❑ Other
❑ Fascia
2.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
ING THE 1997 UBC FEE SCHEDULE)
AL JOB VALUATION $�� 1-9.95LY-)
OCCUPANCY TYPE
Permit Fee
$ ° 93A V
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$ .
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1825 per SAC Unit (Plans to MWCC for determination)
j Curb Cut Escrow
$
ft + 6 ft = ft x $21 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$ % a 6 6)
Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes
of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a
permit on site; that the work will be in a Piork which. requires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME ,t,, J /•.� e --a /K 4 DATE q J - a
APPROVED BY DATE