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PRE 2010 DOCSDate: .. �! ..� .. �'... ' ... .. . Owner + . ... Builder Address ... Address AT® 3091 LOCATION F' BUILDING No. .. �.�! ®® Street .. ........ .... A ... ................. Part of Lot . .............. ........ Lot ....!:(? Block .......... Addition or Sub -Division @... . Corner Lot ..t.......... Inside Lot .. v ..... Setback 3V P 3 1r. ideyard ®.. ....... ' .......... . DESCRIPTION OF BUILDING To Used as: .. Frontp� .. Depth ........ p Heightal�� Sq. Ft. Cu. Ft. ro�..... Depth ? xei ht Sq. Ft. Cu. Ft. ..... Typ�Lonsiruction........ Est. Cost.....® l .`�J?o be Comple/ted ... ...... . I In consideration of the issuance to me of a permit to construct te building d r' ed above, I agree to do the proposed work in accordance with the description above sefqqg�qland in co pan a with all provisions of ordinances of the city of Fridley. - y. :�... In consideration of the payment of a fee of $4_4�d ., permit is hereby granted to ................... ......................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all. work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. NOTICE: This permit does not cover the construction, Installation or alteration for wiring, pluP!i Kg, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these ltbffi& l suB�ecT PERMI City of Fridley 16288 AT THE TOP OF THE TWINS BUILDING PERMIT r RE T . • COMMUNITY DEVELOPMENT DIV. 40 r 1 PROTECTIVE INSPECTION SEC. .3 1 1 � NUMBER REV. DATE PAGE OF APPROVED BY 1 1 1 CITY HALL FRIDLEY 55432 *'' 612-571-3450 910-F15 7/17/81 JOB ADDRESS 6200 Sunrise Dr. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 26 2 Sylvan Hills Add. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Larry D. Va dich. 6200 Sunrise Dr. Fridley 55432 571-8831 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO, 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW Ek ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Construct a screened porch and deck 12' X 16'. 9 CHANGE OF USE FROM TO STIPULATIONS CAXX MR pp � Final Ins tiros educe digglni t$q IVAI u't ei ;.equi toccetomw TELEPHONE - ELECTMI-GO Eby WEEOLON ED BY LAW SEPERATE PERMITS REQUIRED'. HEATING, P11IMBING AND NO& 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 OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R` 1 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 $1,900.00 $.95 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $12.00 PLAN CHECK FEE TOTALFEE 3.00 $15.95 GN TUREOFCONTRACTORORAUTHORIZEDAGENT (DATEI ,i HEN PROPERLY VALIDAHIS IS YOUR PERMIT :VA —17-'gi SIGNATURE OF OW RtFOWNER BUIL DER) (DATE) B DG NSP - DaTE l CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PEM1ITS (lent, Alterations, Additions,, or Repairs) OWNER: 1- Wr"-y ADDRESS: SOb S U IV iZ LS E O R , TEL n0: r---,71 •-5831 UUI LDLR : MItiETOwN Gv �UST�2UCii oN. ADDRESS: 12 • �be. #2 ,CAYYC�i1�1V����,-tet TEL 1.10: l--71 - g7Z-11285 Construction Location STRINT NO: 62�o STREET: S U N 12 lS % t2 t VE LOT: 2 BLOCK: Z ADDITION: LLS AQ 1 I, DN Corner Lot: Inside Lot:^ Setback: Sideyards: Applicant attach to this form two Certificates. of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Gt�u-tom a�. s�n�c,��►�► { t 2 x t � Front: 66pth: Height: Square. Feet: Cubic Feet: Front: Depth: Height: Square -Feet: Cubic Feet: _ Type of Construction: \/\Jd 1 141.4. la Estimated Cost: $ bd Rb Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SFE REVERSE SIDE OF SHEET I.Sie 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 gild rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: -7— 1 G-91 SIGNATURE: Stipulations: 12..cao 3. o0 loop j • BUILDING IIER141T FEE SC{IEDULE' f SECTION 2. - ThZ ln�;pector. of Buildings ull;111, before i;nuing pernnits for the erection of .any buildingl or ;truct:urc, or for: any addition t:o ally existing building or structure, 6r for any, alteration or repairs t0 -any exint-ing bui.l.di,ng or structure, upon application thcr afore, require the payment by the applicant: for such pexmit of fees to the amount herein below set- forth and in the manner herein provided to -wit: 1.1E1•1 CONSTRUCTION: Single 1?amil.y, homes and Garages; Y4.00/1,000 cubic feet. PLAT@ CII1:CK: 25 percent: of building permit fee. DRIVEWAY DEPPESSIOI.1: (Concrete Curb Streets Only) Alternate A: Removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet x $13.50 Alternate B: Removal and replacement of concrete curb and gutter and install a 3 foot wide approach with 6 inch depth; Driveway width plus 6 feet x $15.,75 • —ADDITIONAL I NFORMAT I ON For the purpose of computing fees for building permits,. the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point sir. (G) inches below the floor line of the basement or the cellar to the. average heights of the -upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 Per each five hundred dollars -,($500.00) or fraction thereof in the cost of all proposed work. In -no case shall the fee charged for any permit as set forth in Section 2 be less than $7.50 plus $.50 state surcharge. VERIFICATIOi1 OF FOIJ.L ATION NOTE: 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 been constructed will be required before proceeding with the framing. -FRTIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. U SUBJECT PERMIT NO. of Fridley n o - AT THE TOP OF THE TWINS BUILDING P E R M I T rpCity RECEIPT NO. � • ______ COMMUNITY DEVELOPMENT DIV. v r I PROTECTIVE INSPECTION SEC. �� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/17/83 JOB ADDRESS 6200 Sunrise Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 26 2 Sylvan X Hills Plat 1 SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Lawrence Vaydich 6200 Sunrise Drive N.E. 571-8831 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. L & M Contractors (Not Licensed In Fridley) 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 ❑ REPAIR ❑ MOVE ❑ REMOVE x 8 DESCRIBE WORK Alteration to bedroom basement 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED -EOR V IMN6 "c" ATIN0, ° ,003INI; . ANn cinw TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 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 $21500 $1.25 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $38_50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAI$Fg 75 SIG ATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPER ALIDATED THIS IS YOUR PERMIT UWA, /2 14 BLDG INSP DAJE SIGNATURE OF O RIIF OW ER BUILDERI IDATEI U CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIai FOR RESIDENTIAL BUILDING PERMITS (New. Alterations. Additions. or Repairs) OWNER: lawnvice, V2 i ADDRESS: 6200 SCAN I S (= MOO: BUILDER: I- � K C,VU'� ," OYzs ADDRESS: 302- 3 G6 V& i leg K9, TEL 140: 5 z ?- — 7 I 7 Construction Location • STR=T NO: (J2 0 0 STREET: U N1� Is E Pk I 11 E LOT: �( 6 SLOMS ADDITION: Corner Lot: Inside Lot: X_ 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 aa______ Front: Depth: Height: Q Square Feeta Cubic Feet: M Wr' Front: Depth: Height: Square Feet: Cubic Peet: npe of Construction: Estimated Cost: S 0560 Rb Be Lbr.pleted: AV6- t lq?3 Alt. A Alt. 8 Proposed Driveway Width If Now Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET site undersigned here makes application for • hereby PP permit for the work herein specified, agreeing to do.all work it, strict accordance With the City of Fridley Ordinances and ruli»9s of the DeLmrtment of Buildings, and hereby declares that all the facts and representations stated in this application,pre true and correct. 1� A e DATE: 5 - 17—T3 SIGNATUM: stipulations: Olt. �® 93- �� BUILDING PERMIT FEE SCHEDULE The Inspector of buildings 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 repairs 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 VALUATION FEES $1.00 to $S00.00 $20.00 !Minimum Fee $15.00 plus surcharge $501 to $2,000 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $32.50 for the first $2,000 plus $6.00 for,each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $170.50 for the first $25,000 plus $4..50 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $283.00 for the first $5D,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000 $200,001 and up $443.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof PLAN CHECK: 25 percent of building permit fee DRIVEWAY DEPRESSION ESCROW: Concrete Curb Streets Only Alternate "A": Removial and replacement of curb and gutter only , Driveway width plus 6 feet x $13.50 Alternate 'H": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth Driveway width plus 6 feet x $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 been constructed will be required before proceeding with the framing. "IS -00 z044. $VIP 739.6v Ir L L— I�- 3' �I' z'/z'1 1-1 d t 0 OP L s � f ii Q'yp�- Av 01 SUBJECT PERMIT N city ®f Fridley '0 5 5 1 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT 0 6 L'__�___ COMMUNITY DEVELOPMENT OIV. / y -y Q r PROTECTIVE INSPECTION SEC. 3 / / i CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED By 612-571-3450 910-F15 9/4/90 JOB ADDRESS 6200 Sunrise Drive N.E. 1 LEGAL LOT NO. TRACTOR ADDITION SEE ATTACHED DESCR. 26 [BLOCK 2 Sylvan. Hills Plat 1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Patrick Faber 6200 Sknirise Drive N.E. 572-0947 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 Ck NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 161 x 101 Storage Shed 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $150 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $20.0 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $15.00 P N CHECK FEE TOTAL FEE re SC $.20 15,70 SIGNATURE OF CONTRACTOR U IZED AGENT w t TEI HEN PROPERLY VA IDATED THIS IS YOUR PERMIT SiGNATURE OF OWNER 0F OWNER BUILDER) IDATEI BLDG )NSP lAT 01 NEW Effective 8/16/90 ADr-N R-1 AND R-2 ALTER Building Permit Application Construction Address: Legal Description: Owner Name & Address: Contractor: Tel. #, Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. "k - LIVING AREA: length Width Height _ Sq. Ft. GRPUAM AREA: length Width Height Sq. Ft. DEM AREA: length Width Hqt/Ground -7— Sq. Ft. 07HER: Corner lot [ ] Inside Lot Type of Construction: Approx. Completion Date: �L /- N Ft. Yd Setback' Side Yard Setbacks Estimated cost: $ -&Moo Proposed Driveway Width If New Opening Is Desired: Ft. $-- idth + 61 See Back Page 'b APPLICANT: Tel. -7 /, tr # r ?o 4--,/ Permit Fee Fire Surcharge State Surcharge SAC Marge Driveway Escrow Park Fee Sewer Main Charge STIMIAMONS: lz!), M) Q G MY USE CNLY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th $.50/$1,000 Valuation $600 per SAC Unit Alt. IWI or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary 7he 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: $1 to $500 $15 (Minimum Fee is $15 plus sur Ulrge) $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 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. Permits for construction will be issued a minimlm, of 24 hours fi-oam 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. IT NO. City ®f Fridley r76 2 0 4SUBJECT AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. •V ������� COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �/ J� z4? r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 L J` 612-571-3450 910415 6/10/98 JOB ADDRESS 6200 Sunrise Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 26 2 Sylvan Hills Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Patrick/Maureen Faber 6200 Sunrise Drive NE 572-0947 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 7 CLASS OF WORK ❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Convert 12' x 16' Screen Porch to Three Season Porch W/Windows 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 $1,678 $.84 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- $54.00 Fire SC $1.68 STRUC NOR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE ;�^-- fp "O ge $56.52 SIGNATURE OF KONTRACTOR OR AUTHORIZED AGENT IDATEI WHEROP Y VA (DATED THIS IS YO RPE MIT v eDG INSP � DATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] Effective 1 / 1 /98 ADDN [ ] CITY OF FRIDLEY �I ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �® ConstructionAddress: l O L5'1'V Legal Description: �-�� Owner Name &Address: LLr Tel. # S7� Oi 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 IlVIPROVEMENT16&p jaxo., LIVING AMA: Length Width Height Sq. Ft. -7Y GARAGE AREA: Length Width Height. Sq. Ft. lid DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: oz -'A y eA^ '�;CA_,e� i Cy, 1-0 3'� Construction Type: Estimated Cost: $ (Fee Schedule on Back) Ft x $ = $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = STIPULATIONS: i3l�/D " ? / 3�) DATE: `��1 APPLICANT: Tel. # CITY USE ONLY Permit Fee $ � Fee Schedule on Reverse Side ?ire Surcharge $ .001 of Permit Valuation (1 / 10th %) State Surcharge $ �('� $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $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: 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 $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.