The URL can be used to link to this page

PRE 2010 DOCSCITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL MXII-,er Fixtures X $3.00 $ 00 Future Fixture Opening X $2.00 $ New :4xture, Old Opening X $2.00 Catch Basin x $5.00 rd Water A eater - to 99,000 0 B I TUX 0 $5.00 $ 0 X Water ..Water sufteier X .0 New Ground Run Old Building X 0 �4 X $5.00 GAS FITTING FEES: 01 0 ri 4) H Additional Fixtures X $4 E� r. •-4 _4 q W 74 a *'$10.00 V (d $4 RC 9 Heater -,4 W W CJ �) .1 M C each acid.. $100. 00 or fraction C -4 W 1 -- X 41 r. z State Surdharge 10, .0 . -rH S .0a TOTAL 'FEE 54 FEE ($10.00) -f $4 4J En .,1 :3 0 4J U) .1.3 U) CO U) U) �04 i U M 'Eno M En �4 0 go Cn -4 54 (d 0 (d 0 as led :nd 3 4 t, (R) = Future Connection Opening Connected with Sewer New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL MXII-,er Fixtures X $3.00 $ 00 Future Fixture Opening X $2.00 $ New :4xture, Old Opening X $2.00 Catch Basin x $5.00 Water A eater - to 99,000 0 B I TUX $5.00 $ 100,000 BTU to 199,000 BTU X $10.00 ..Water sufteier X $7.00 New Ground Run Old Building X $5...00 Electric water heater X $5.00 GAS FITTING FEES: 1st 3 fixtures 1 x .•$3;00 Additional Fixtures X $1.00 Gas tan4e to 199, 000 BTU X *'$10.00 REPAIRS &. I ALTE*RNTIOIvS First $100.00 $5.00 each acid.. $100. 00 or fraction State Surdharge 50 TOTAL 'FEE RE1NSPEC7IQN FEE ($10.00) Job Address 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. 19 a ROUGH INSP. Date FINAL INSP. APPROVAL -.FOR! PAR!jIT ;MINIMUM PM.POR•A": PLUMBINW PERMIT Is$7,SO PLUS $,50 STATE SURCHARGE CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING. PERMITS:. C� '(NEW, ALTERATIONS,..ADDITIONS, OR. REPAIRS) OWNER: `AWL BUILDER: �Vt ! s Address: r ss• Tel. No. No.. LOT: Street: BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS: Applicant attach 'to this form Tao Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: Estimated Cost: $ ` To Be Completed: Alt. A Alt.. B Proposed Driveway Width If New Opening Is Desired $ v $ (SEE REVERSE SIDE OF SHEET) The 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side for additional information. DATE: 0 zon o07 SIGNATURE: Stipulations: i 6 -If �- e��wz �� C- t)g ,eeC r CITY OF FRIDLEY _. APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE ' GRAVITY WARM AIR: RATE TOTAL Job Address Furnace Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Department of Buildings Repairs & Alterations each add. $500.00 4.00 $ City of Fridley Tel. #571-3450 MECHANICAL WARM AIR: The undersigned hereby makes application for a permit for the work herein Furnace Shell & Duct Work to 100,000 BTU $12.00 $ specified agreeing to do all work in strict accordance with the City Codes .r. each add. 50,000 BTU 4.00 $7 :�:pZ and rulings of the Department of Buildings, and hereby declares that all the Replacement of Furnace 7.00 $ facts and representations stated in this application are true and correct. Repairs & Alterations -up to $500.00 7.00 $ v �Caa� 19 �1 Repairs & Alterations each add. $500.00 4.00 $ Fridley, Minn. , STEAM OR HOT WATER SYSTEM: / ' OWNER �i �� / 1 Gt L a !- Boiler & Lines up to 100,000 BTU $12.00 $ KIND OF BUILDING 4k,410 C each addn. 50,000 BTU 4.00 $ /� Boiler only up to 100,000 BTU 7.00 $ USED ASGiO l each addn. 50,000 BTU 6.00 $ A TO BE COMPLETED ABOUT - OIL BURNER- to 3 gal. per hour $10.00 $h' �)6 each add. 3 gal. per hour 10.00 $ ESTIMATED COST a � / ff[ PERMIT NO. GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ / OLD - NEW BUILDING PERMIT NO. (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: lst x $ 3.00 $ s 3 Fixtures DESCRIPTION OF FURNACE/BURNER Additional Fixtures x Gas Range to 199,000 BTU x $ 1.00 $10.00. $ $ HEATING or POWER PLANTS, Steam,_Bot Water,arm Air' No. AIR CONDITIONING $ Trade Name A" J 0/ Size No. FAN HEATING SYSTEMS See Fee schedule $��//L9 VENTILATING SYSTEMS $ Capacity Sq. Ft. EDR BTU A� o r �' HP ALTERATI ONS $ REPAIRS __ . State Surcharge $ .50 Total Connected Load ?.r� Kind of Fuel +s4 �ly� TOTAL FEE $-ai--,C- 5C BURNER - Trade Name '�/ eez"U, yf 1,/ Size No. fy J� _ /Gad ROUGH INSP. REINSPECTION FEE Date ($10.00) FINAL INSP. Date APPROVAL FOR PERMIT ®� MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE Capacity Sq. Ft. EDR BTU 16 :, 6 -c -z HP Company IRAWS AT[Mr. AMD AIR CnNnIIJONING IN 3107 CALIFORNIA STREET NORTH EAST Signed By Tel. No PNf1N��81=9 6 a HEAT LOSS CALCULATIONS 69/ DEPARTMENT OF INSPECTION MINNEAPOLIS. MUNI. Weatherstrips � �� Consbuction No. Insulation Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied es-- o I _Ws 19_. _ Fl.� oom Length Width �r eight Y II Room I Lenath A_ Width -Vr , Heiaht Windows and Doors—Crackage and Area tcoom ILengM 14 Wfi9t4t. Width Height No. of Lineal f . Area No. of pane of pane lights of crack sq. ft. Windows and Doors--Crackate and Area N �s JV8.0 a Coef.1 Btu Infiltration Coef.1 Btu Infiltration ', � �) r Glass Glass '-'ro slo Exp. Wall 3® y, I A AA I Net exp. wall Net exp, wan / Int. wall / 6 Int. wan Ceiling 10 , Ceiling ).'- !.s em Floor < Total Btu. I C o Required sq. ft. E.D.R. or sq. ins. W.A. Leader area i. Fl.l .-. 'Room I l enA 1,4-4- Width IS- - Heiaht Windows anR Doors--Crackage and Area tcoom ILengM 14 Wfi9t4t. Width Height No. of Lineal tt. Area No. of pane of pane lights of crack sq: ft. Windows and Doors--Crackate and Area AU �s JV8.0 a Coef. Btu Infiltration Coef.1 Btu Infiltration ', � �) r Glass Glass -T slo Exp.. wall 3® y, I LA 7A I Net exp. wall Net exp: wall Int. wall / 6 Int. wall Ceiling 10 , Ceiling J Floor Floor e Total Btu. e i, _"s Required 'sq. ft. E.D.R. or sq. ins. WA. Leader. area _I. r1.1 43 Qd4 tcoom ILengM 14 Wfi9t4t. -& t Windows and Doors--Crackate and Area Width Height No. of Lineal ft. - Area No. of pane of pane lishtr of crack sq. ft. JV8.0 a lCoef.1 Btu Infiltration Glass Coef.1 Btu Infiltration ', � �) r Exp. wan Glass Al *?. a T5 a a C Exp. wan .s Net exp. wall Int. wall Int. wall Ceiling Ceiling 10 , Floor Floor Total Btu. I- //) 4f :'j Z Windows and Doors—Crackage and Area Width Height No. of Lineal tt. Area No. of pane of Dane lights of crack sq. ft. /pane lCoef.1 Btu Infiltration Glass �. ', � �) r Exp. wan F e Net ev. wall Int. wall Ceiling k 10 , Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area I i Fl.l 4. Room I Length j , Width / 7-A _ Heiaht v Windows and Doors—Crackage and Area Width Height, No. of Lineal ft. Area Noa of pane of lights of crack sq. ft. /pane Coef. Btu Infiltration 4 ', � �) r Glass Exp. wall F e Net elfp. wall Int -wall Ceiling k 10 Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area Room I Length Ia Width a Windows and Doors—Crackane and Area Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area II Required sq. ft. E.D.R. or sq. ins.. W.A. Leader area Btu 74 November 23, 1977 •� h. y III' - 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 812)571-3450 Mr. Bob Mikulak 8241 Riverview Terrace N.E. Fridley, Mn. 55432 U Re: Final Inspection at 8241 Riverview Terrace N.E. Dear Mr. Mikulak: A final inspection was made on November 22, 1977 of the above address and the following items were noted which must be completed before the structure can be finaled out; 1. Submit copy of verifying survey to the City by December 15, 1977. 2. Install 5/8 inch type X sheetrock on wall between house and garage by December 15, 1977. 3. Provide permanent step to garage by December 15, 1977. 4. Submit infrared report on foam insulation by February 1, 1978. 5. Provide sod in the front and side yards by May 31, 1978. We will expect the above items to be completed by the scheduled dates when reinspection will be conducted to determine compliance. If you have any questions on the above items, please contact me at 571-3450. Sincerely, . . . li��o DARREL G. Community Development Adan. DGC/mh 977 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 612)571-3450 Mr.. Bob Mt ufl,lak 824: RiverV ew Terrace N.E. Fridley, Mn. 55432 Re Final Inspection at 8241 Riverview Terrace N.E. (SECOND NOTICE) Dear Mr. Mikulak: A reinspection was made on December 15, 1977 of the above structure to determine if items noted in our letter to you dated., November 23,.1977 were completed. We were not able to gain admittance to the dwelling at that time. We would like toset up a reinspection for sometime within the next three weeks whenever it would be convenient for someone to let us in. Please contact us to set up a date when this reinspection could be made. Sincerely, DARREL G. CLARK Community Development Adm. DGC/mh UsATEMENT OF INTENT To Make An Improvement In The Primary Flood Hazard Area Applicant: _ ,-,� Owner: Legal Description: Site Address: Describe Type of Improvement: 11) AI a hi 0' Mean Elevation of Improvement Site: ' Regulatory Flood Datum Elevation: Q,®�f� .�• �� Pu�� Sketch Lot and Proposed Construction on Lot: 7 V P A! U T j4 - V r1)Q1V T ` a 2 -7, -7 ? r NOTE: NO FLOOR ELEVATION CAN BE BELOW THE REGULATORY FLOOD DATUM ELEVATION s % "ERTIFI-CATE OF SURVEY JAMES L. KURTH LAND SURVEYOR 4201 N.E. STH STREET COLUMBIA HEIGHTS SS421 7198.50-14 I HEREBY CERTIFY THAT THIS SURVEY, PLAN. OR REPORT WAS PREPAREO BY ME OR UNDER PAY F)IRFi•T SUPERVISION AND THAT I AM A DULY REGISTERED LAND SURVEYOR UNDER THE LAWS OF THG SYATE OF MINNESOTA MINNESOTA REGISTRATION NO- 5332 IRON MONUMENT - Q t�j � -10 •_L _ 1 ' Ju2v��c c, c= 1 City of Fridley SUBJECT PER 14351 AT THE TOP OF THE TWINS BUILDING PERMIT r Z RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r t PROTECTIVE INSPECTION SEC. IS� t . � NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-560-3450 910-F15 9/9/77 JOB ADDRESS 8241 Riverview Terrace N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 27-30 Q Riverview Heights SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Robert Mikulak 1420 - 3rd Street N.E. 781-1604 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER M%tDqM OF Malt DQr.S t4W CWARARYEE TF-; PHONE LICENSE NO. QP UUM t"Aft" AM- ELEVA71C ' 5 ENGINEER M"y&DVA% IS roll I" "PNI0315 ONLY ANj PHONE LICENSE NO. P °NK R NIQ", VlR VW 000AMATION 6 USE OF BUILDING ON THP Ift Residential 7 CLASS OF WORK Ij NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MO VAID 111W 8 DESCRIBE WORK Construct a 32' x 29' Dwelling and a 221-x 24' Garage ,before digging Celt focal U • . • i SEEPERATE PERMITS REQtARED FOR WIRING "MUlar- BY AA 9 CHANGE OF USE FROM HEATING PLUWING Air STIPULATIONS Provide a.hard surface driveway. Provide sod in the front and side yards. Provide a verifying survey before capping. Provide City with copy of truss design before capping. Provide vapor barrier in ceiling. Core fill d rod t �n footevery 8 feet around block foundation. Provide waterproofin on basement walls with black poly. Provide gate valve on sewer outlet. Submit proposed building elevations prior to calling for footing inspection for verification with respect to the 100 year flood level. SERVICES OFF RIVERVIEW TERRACE SEWER LOCATION: (Approx. 9' Deep In Street) 65' S. of Manhole (Janesville & Riverview Terrace) WYE ELEV: 815.18 TOP OF FOOTING: 82.1.2 Minimum. WATER LOCATTIfON: 58�.T-1/' S. of Manhole, 10' N. of Sewer Service MINIMUM GRADE AT FOUNDATION: 825.2 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-1 964 + 528 24,528 Total 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 $35,450 $17.72 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. $98.11 $375.00 PLAN CHECK FEE TOTALFEE 00 . 3 1 g 515.36 W N PRO E A ID D H -IS -IS SIGNATURE CONTRACTOR OR AUTHORIZE GTE) 4hERMIT SIGN OF OWNE I W ER u D ) IDATEI BLDG INSP E W i • CITY OF FRIDLEY_,�_�� APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS,•OR REPAIRS) OWNER: Address: No.: 8Q Street: BUILDER: 1 cp'l: M I � � Address: 2V Tel. No. ! aI — '(dz�c J IE"A0 r LOT: off`) , ��,�® BLOCK: � ADDITION: CORNER LOT: ✓� INSIDE IAT: SETBACK: 24r SIDEYARDS: 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: r Front: Depth: , Height: off® Square Feet: Cubic Feet: 00 &PACO Front: Depth: : Hei ht: �r�_ De g �� Square Feet: Cubic Feet: Type of Construction: Woo 6 �i�i71 EEstimated Cost: $ o To Be Completed:Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired 1 ' $ OF $ (SEE REVERSE SIDE OF SHEET) The 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side for additional info rmatio . DATE: o / SIGNATURE• Stipulations: �L `S ujt L 2/2 (Ak G WMAM t q8.)1 Qy- .00 ce { P Z " folow CAT 4002 dEFFFtB�I$TS1X� a� ail COLUMBIA H€K."J:S``• tai k t� xx� %y y yr r,a t Tl111T ! 11AA 4i X J�" +tet MiNNE T RE$,'' r 53 0 4'k,ti�fi�' .'�iip�t`y`I�.,�w fy G3 E JPi ,�V� ': ` , . Ott � � Y✓i j �' +qs ` h �5��'¢�r, ........aL•.-•f•^ M1'd�•L` h"k '°:eC$ x 12 :� 7'a It r 1 r a, 1 f� 4r; .A� ✓ Z i r 7 f DO' NOT• DS,L U R_ as•F AQ 4 � r r.° Y r - 7W9766 rad1,)t IMY,'CNRECT ilJT6ltV/810P1 r� �� • AttFll�7`A. ATE P Pu ©i .,Yz 1>ytOJN MONUMENT AN✓� I '� b� "3 11 I f l T } r .►EIEi O I O A i 30 DAY NOTIdt f0 Cl ®I u1iiitl�S pll j, REt t IRE@ " � y , TEIEPiiONE ® ELECT C - �, ,s Etc. s� �® V L r4lC�tEP.LAl1i� }. t < gp�y��) may/ :iE$V'Y�O t A cit r R� UjRED • �a PW AT 28 ._ .^�tl } THE OTO :,PF ACCUG@ACY OF uptoy THIS"®�+UXtS i Oi ' O - „r 6NAA 4 y y { }1� 7 J' as r,�r" $srr' 'R • ;'i3 ,{�'k �r• s,�, 4r.� '��i.l {gyp 1 Q �'�% ly-1� F � i l�"��• I �C7 w eD �� o4i 77Per 40 El I EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER SITE ADDRESS CONTRACTOR DATE 207ADNE -7iff/604 Determine working square footage of each. 1. Total exposed wall area . . q 4�_sq. ft. x .17 = 2. Total roof/ceiling area . . . . � 'g _sq . ft. x .OS = �,;9� : 012 Total exposed wall area above floor = a. Total wall window' area . . . . . . . . . . . b. Total door area . . . . . . . . . . Ay - C. Total sliding glass door area . . . . . d. Total fireplace wall area . . . . . . . . . e. Total wall framing area (average 10%). . . . f. Total net wall area above floor. . . . . . (22 g. Total rim joist area . . . . . . . . . . . . _. Total exposed foundation area h. Total foundation window area . . . . . . . i. Total net foundation area above grade . . . Determine "U'l value of each wall segment. a. X _ flulf S _ !� b. X fluff C. X fluff d.'_ X fluff = e. X flu if f. 64- g' X flu 11 b. X hull i. ' X fluff 3. . . . . . . . . . . . . . . Total. If item JJ3 is the same as, or less than item #1, you have met the intent of SBC 6006 (c)2. a I Heat flow up F] TYPICAL VALL SECTION 1. Interior Air Film 2. Interior Wallboard 3. Insulation=lllqc� 4. Exterior Sheathing 5. Exterior Siding 6. Exterior Air Film Total STUD & HEADER AREA Total Area No. 1 Less Insulation "R" Plus 332-t' Softwood Total RIM JOIST AREA t, 'OR" 0 �`i SOU R=U _11 _ 1. Interior Air Film s -- 2. Insulation 3. 1V Softwood Lr In - 4. Exterior Sheathing – 1 5. Exterior Siding-- R = U 6. Exterior Air Film Total - U FOUNDATION WALL AREA 1. Interior Air Film e7 2. Insulation 3. Insulation (Block)lR = U 4. Exterior Air Film d L Total U ROOF/CEILING AREA 1. Interior Air Film_ 2. Interior Wallboard �'- 3, Insulation 4. Exterior Air Film " �t5 U (Still) U– Total Total exposed roof/ceiling area = '70, j. Total skylight area.. . . . • • . k. Total roof/ceiling framing area . . . . . 1. Total net insulated roof/ceiling - Determine "U" value for each roof/ceiling segment. j;I ®. X fluff k. X +'Un 5 fluff .� c/ _ X_ 4 . . . . . . . . . . . . . . . . Total If total of #4 is the same as, or less than #2, you have Miet-the intent of SBC 6006(c)l. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of items X13 and #4 shall not be greater than the sum of items #1 and #2. 1. q, NEW , [ ] CITY OF FRIDLEY ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: 67,4f Legal Description: Owner Name & Address: 8 lel Tel. #16:13 2" Contractor: MN LICENSE # Address: Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: 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 Length Width Hgt/Ground Sq. Ft Construction Type: tt;5 SQ- Estimated Cost: $ i2-6 Driveway Curb C Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 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 [ ] TOTAL $ PT STIPULATIONS: