PRE 2010 DOCSVillage of Fridley, Mina.
�i
Oli MUSING PFM"
N .
993 Office of INSPECTOR OF BUILDINGS
owner,
Architect Fridley, Minn., 19
1
Builder
'I
li
LOCATION OF BUILDING
No. Street " ' Part of Lot
Lot_ BIock Addition or Sub -Division
DESCRIPTION OF BUILDING
Front__ __v_' Depth Height Stories ''y :Manner of Construction_
To be used as To be completed Estimated Coat
j
III i
-Permit is hereby gamed to to
the building described in the above statement. This permit is granted
upon the express c clition that the person to whom it is anted, and his agents, employees and workmen, in all
Po xP �� Pe �'
the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley, llM -nn., regarding the 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, it
€y.
Inspector of Buildings.
li
AGREEMENT AND SWORN STATEMENT
in consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above permit, i hereby agree to do the proposed work in accordance with the description
above set forth „and according to the provisions of the ordinances of Fridley, and, being first duly
sworn, I herebyl'state and say that the facts stated by me and contained in the above permit are
true as therein Mated.
I�
Subscribed, and sworn to before me at Fridley, Minnesota; •.this
r:
day of ° : �` A.D.
Village of Fridley, Mwn.
g y�
BUILDING PERMIT.'
O
Office of INSPECTOR OF BUILDINGS
Permit is. hereby (grant
the building -',f described in the above statement. This permit is granted
upon the express condition thAt the person to whom it is granted, and his agents, employees and workmen, in all
the work done in, iraround and upon said building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley,Anna., regarding the 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.
Spector of Buildings.
AGREEMI,N'i' AND SWORN STATEMENT
In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above permit, I hereby agree to do the proposed work in accordance with the description
above set forth li'and according to the provisions of the ordinances of Fridley, and, being first duly
sworn, I hereby, state anti say that the facts stated by me and contained in the above permit are
true as there* stated.
sworn o before me at Fridley,
Minnesota s
Subscribed d sw t y, ,
day o� row.. .D. 19'..
City of Fridley
Application for Plumbing and Cas Fitting Permit
Dept. of Bldga. Phone M-3450
DESCRIPTION OF WORK Location /� S
Number, Kind and Location of Fixtures `��
pp
F
y3
3
s
� a
yy1
Y
Number Fixtures ......................
tyo
�
O �
Future Fixture Opening ................
u 1
(taj Z
l)
O w
<
1 °d
O
9 aS
0
Z
90
F
•
N
WATER HTR.
GAS
ELEG
Base
✓ x $3.25
It 5.
Electric water Heater
z $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ...... ...................
x $2.00
$
Additional Fixtures ....................
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
1st
2nd
_
3rd
4th
• Future Connection Openings
* New Fixture, Old Openings I
Connected with
Sewer
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
'`�
Number Fixtures ......................
x $200
$
Future Fixture Opening ................
x $1.50
$
New Fixture Old Opening ..............
x $1.50
$
Catch Basin ............................
x $3.25
$
Water Heater (Up to 99,000 BTU) ......
x $3.00
$
New Ground Run Old Bldg. ............
✓ x $3.25
It 5.
Electric water Heater
z $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ...... ...................
x $2.00
$
Additional Fixtures ....................
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ...............................................$
TOTAL FEE $
City of Fridley:
The undersigned hereby .makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and
and correct. //
Fridley, ML
inn < 14ir
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old—New. Building Permit NoPermit No. 'y<i�55
Signe
✓z
4
rl
B
Business Phone No
ROUGH -
FINAL
.4110�0.42
SUBJECT
City of Fridley
jER
®
AT THE TOP OF THE TWINS
BUILDING PERMIT
_20i53
f
ECEIPT N
�
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
%
19
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
,,
L 612-571-3450
910-F15
10/13/89
JOB ADDRESS 6512 Stinson Boulevard N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
3
Moore Lake Park lst Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Jeanne Stinson 6512 Stinson Boulevard N.E:
571-4812
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
R & M Associates 3482 Auger, White Bear Lake, MN 55110.
770-9322
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 R REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Vinyl
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
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
$4000 300
$2,15
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-
$72.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$74,15
SGNATONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERLY VA
ATED THIS IS YOUR PERMIT
K
SIGNATURE OF OWNER OF OWNER BUILDERI (DATEi
BLDG WSP
ATE
NEW [ l
ADEN [ ]
ALTER [ )
R-1 AND R-2
Building Permit Application
Effective 5/1/88
Legal Description:
M
owner Name & Address: —
1-T—
Owner& Al F 5'7—iry SdA,� Tel. #
Contractor: _9-f IYI J4 55® r Tel. #,770-q32-2--
Address:
,'70-q32-2Address: 3'/
Attach to this application, a Certificate of Survey of the
lot, with the proposed cons xucticn drawn on it to scale.
,
I�CRIPTI�T OF MEN=
_InMG AM: Length Width height Sq. Ft.
MMUM AM: length Width Height Sq. Ft.
DECK AREA: lergth Width Hgt/Ground Sq. Ft.
On=:
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yana Setbacks
Type of Construction: IVE w 5`/ /'V(//,v v/ Estimated cost: $ 4/, 3o o e
Approx. Ompletion Date: —�
Proposed Driveway Width If New opening Is Desired:
DATE: Lf3 APPLICANP:
Permit Fee $ /%c�, 00
State Surcharge
SAC Charge $
Driveway Escrow $
Park Fee $
Sewer Main Criarge $
STIPUTATIMS:
Ft.
Width + 6'
CITY USE ONLY
See Back Page
Fee Schedule on reverse Side
$.50/$1,000 Valuation
$575 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Exjhx*xing
Agreement Necessary [ ] Not Necessary [ ]
:•Iv 4:" : •ars �1
The Chief Building official shall, before issuing ng permits for the erection of any
building or structure, or for any addition to any adsting building or structure, or
for any alteration or repair to any Wasting building or structure, upon application
therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provi 't:
$1 to $500 $15 Minimum Fee is $15 plus urge)
$501 to $2,000 $15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction thereof
DRIVEMY I ISSICK ESCROW
(Concrete Curb Streets only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus
6 feet times $13.50.
Alternate "B": R Twval and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
Permits for construction will be issued a minimum of 24 hours from the time of
application to allow for proper review of the proposed structure and of the
construction site.
A Oertificate of Survey of the lot, showing the location of the foundation on it has
it has been constructed will be required before proceeding with the framing.
go ., .
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
December 4, 1989
Ms. Jeannie smestad
6512 Stinson Boulevard N.E.
Fridley, MN' 55432
Re: Address Change Effective January 1, 1990
Dear Ms. Smestad:
As we discussed on Frj&4, Decexber 1, 1989, the City is going to dWEP Your
address fran 6512 Stanson Boulevard to 6540 Stinson Boulevard. Me reason for the
necessary change is that yaw present address is out of sequence with the other
- .bboring homes in your:block.
We realize that this IS M inconvenience for you, however if an emergency should
arise at your hame, it is',very important that emergency personnel find your home
as soon as possible, and w th your present house unmlher critical time Could be lost
trying to find your home.
The change will be effective January 1, 1990 to allow you some time to notify your
friends and relatives. qxe City has notified the cmpanies and departments listed
on the enclosed letter.
Thank you for your cooperation in this matter and if you have any questions, please
call me at 571-3450.
01
a w1k ol
DARREL G. CTARKChief Official
DGC/mh
ENC: 1
-' -
SUBJE&
City of Fridley
28242
.�ff6 -F THE TWINS
BUILDING
P E R ill I
NO.
• COMMUNITY DEVELOPMENT DIV.
____
1 V -
PROTECTIVE INSPECTION SEC.
���
r 1
1 �
NUMBER
REV
DATE
PAGE OF
APPROVED By
i CITY HALL FRIDLEY 55432
�____1l: '•�
612-571-3450
910-F15
10 14 98
JOB ADDRESS 6540 Stinson Blvd NE
1 LEGAL
LOT N0.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
4
3
Moore Lake Park 1st
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jeanne Smedstad
571-4812
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Seal Guard Systems 9199 Central Ave NE Blaine 55434 717-0700
20093688
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 )a REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage (19 Sq) Tear-off; Replace 2 windows
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
Install smoke detectors to meet the State Building Code -
in each sleeping
room and on each level of house.
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
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 13E COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
1628
.81
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
54.00
Fire 90 $1.63
PLAN CHECK FEE
2,$
TOTAL E
Licen C
OD
SIGNATURE OF CONTRACTOR OR AUT04ORIZEO AGENT IDATEI
N P PE (DATED SIS YOUR PER IT
s
SIGNATURE OF OWNERSIF OWNER BUILDEAt IDATEI
BLDG JNSP
OATS
iL TT ` ,
ADDN • [ ] _ F CT!'QF FRIDLEY
ALTER [ ] SINGLE FA MY AND -DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstiuctionAddress: L
Legal Description:
Owner Name & Address:
Contractor. Seal (
Address: q I qq C.tn
Ski
N& Fri&l
I Tel. #
LICENSE # o nbq 36
Tel.# 9I r7— df%CO
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EMPROVEMENT
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: k- PM� q F&g)Estimated Cost:
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: l APPLICANT: Tel. # riamoo
TOTAL $ � ` ' C q
STIPULATIONS:
CITY USE ONLY
Permit Fee
I I
$ °`i ' o
Fee Schedule on Reverse Side
Fire Surcharge
$ .
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 4"81
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ 6) ®d
$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 $ � ` ' C q
STIPULATIONS:
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to -wit:
TOTAL VALUE FEES
$1 to $500 $21 (Minimum Fee is $21 plus surcharge)
$501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $i,000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $349.75 for first $25,000 plus $y.W tur each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
SuBjECTIT
J
NO.
City of Fridley
2 9 375
AT THE TOP OF THE TWINS
I IIL®ING
BUILDING
PEDA AIT
RYCEIPT NO.
` COMMUNITY DEVELOPMENT DIV.
L ___ -__
INSPECTION SEC.�'j,
r PROTECTIVE
1 "'1 CITY HALL FRIDLEY M432
NUMBER
REV
DATE
PAGE OF
APPROVED 6V
612-571-3450
910-F15
5/3/99
JOB ADDRESS 6540 Stinson Blvd NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR,
4
3
Moore Lake Park 1st Addtiion SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jeanne Smestad 6540 Stinson Blvd NE
571-4812
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
T CLASS OF WORK
❑ NEW ❑ ADDITION (j ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 121 x 12' Screen Porch and a 7' x 12' Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday
thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
WANING
Before digging call for
all atillty locabons
;EPARA PER
454-ON2
. �,�.S
RING, ��ATi P U'RMFps► F?LrQ
REVU��ED BY Ll� —NG
AND
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 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
$1.67
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$3,349
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
PLAN CHECK FEE
TO L FEE
&AUITHORIZED
$92.27
��SIGNA�TUREOFONTRACT AGENT IDATEI
HE PR
VALID ETHIS Is M17
8�& INSp
I �
gAiE
SIGNATURE OF OWNERoF OWNER BUILDERI IDATEI
NEW [ ] Effective 1 / 1 /99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION ? ��
ConstructionAddress: k',S `f ® �j I rySDx9 �j v
Legal Description: q _
Owner Name & Address: ^ ,� 25 M e's`� � Tel. # S 7 ! L/ 37 ✓i
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 EWROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width �_ Hgt/Ground Sq. Ft., 2L'N,, Y�
OTHER: 19V 12— = 11VIvI,7. � � 7%- 7�-
Construction Type: S c-viex,Y, PbRc( °'v dec.t Estimated Cost: $ z� "
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: Tel. # ,-7/ - /A
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
$ r7.2S'
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
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ . Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ 2 -
STIPULATIONS:
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to -wit:
TOTAL VALUE FEES
$1 to $500 $21 (Minimum Fee is $21 plus surcharge)
$501 "to $2,000 $21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued,a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
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