PRE 2010 DOCSDate:
owner: Builder
Address Address
N° .6908
LO�tTIO&ffOF BUILDING
No. Streets_Part of Lot
LotBlock --_--- Addition or Sub -Division .
Corner Lot Inside Lot Setbacks _ Sideyard r/
Sewer Elevation s Foundation Elevation VA
DESCRIPTION OF BUILDING
7 U "'2- Cu. Ft� `
Front Depth Height Sq. Ft.
Fron Depth Height _ �Sq. Ft. Cu. Ft.
Type of Constructs Est. _ _ To be Completed
In consideration of the issuance to me of a permit to constmict the b din described above, I agree to do
the proposed work In accordance with the description above se rth and pliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of , 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
within the city limits and this permit may be revoked at any tune
ordinances uppn vidpn of any of the provisions of said
� � f 11 � V
NOTICE
'hb pemb don not corer the condn%*on, instaWan for wh%& phmbtng, gas heding, sewer or wafer. Be sure to see
the BuNing hupod er for separate permhs for these hems,
OWNER ° S NAME
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
ADDR74SS ADDRESS
LOCATION OF BUILDING
s
No. �® Street f�„� Part of Lot
Lot Block �� Addition or Subdivision
Corner Lot Inside Lot Setbacks� Side Yard S
SEWER ELEVATION FMMMW ELEVATION S-6
9� �® rem rak,�
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
DESCRIPTION OF BUILDING
To bA used as:
-® Front Depth Height
Sq. Ft. /x, F Cu. Ft. e9
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction �� Estimated Costo �.
To be Completed
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.
DATEW/ SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
BUILDING PERMIT FEE SCHEDULE
Section 2. The Inspector of Buildings shall, before issuing any permit for
the erection of any building or structure, or for any addition to any exist-
ing building or structure, or for any alterations or repairs to any existing
building or structure, upon application therefor, 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:
2.1. For any such permit for_the erection of any fire -proof building, other.
than a garage' warehouse, factory or grain elevator, or for the erection.of
any fire -proof addition, for similar occupancy, to any existing building
shall be at the rate of $1.40 for each one thousand cubic feet, or fraction
thereof, in such cubical contents.
2.2. For any such permit for the erection of any fire -proof garage, warehouse,.
factory or grain elevator, or for the erection of any fire -proof addition,
for similar occupancy, to any existing building shall be at the rate of $1.25
for each one thousand cubic feet, classified as "fireproof" by Section 502 of
the Minneapolis Building Code.
HOUSES
2.3. For any such permit for the erection of any non -fireproof building other
than a garage, warehouse, factory or grain elevator, or any non -fireproof
addition, for similar occupancy, to any existing building - permit $1.00 for
each one thousand cubic feet.
GARAGES
2.4. For any such permit for the erection of any non -fireproof garage,
warehouse, factory -or grain elevator, or for the erection of any non -fireproof
addition, fors3.milar occupancy, to any existing building or for each such
building or addition ninety cents ($0.90) for each one thousand cubic feet
or fraction thereof', in the cubical contents thereof. with a minimum of $4.00.. -
For the purpose of computing fees for building permits, the cubical contents
of any building or addition to a uniform height throughout by multiplying the
ground area covered from it point six (6) inches below the floor line of the
basement or cellar to the average height of the upper surface or to the
average height of the roof surface of the main gable of a pitched roof.
2.5. 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.
2.6. In no case shall the fAp;. charged for .any permit as set forth in
Section 2 be less than $4_00.
City of Fridley
Application for Plumbing and Gas Fitting Pern*
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ......................
x $1.50
{10
iii
i
Z tz
rxnu�j�jO
x 1.00
$
Catch Basin ............................
J
wU
a
Z
C�y0
F
•
N
WATER HTR.
GAS
ELEC.
Base
GAS FITTING FEES:
NO. RATE
1st 3 Fixtures ..........................
x $1.50
>TOTAL
$�La
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
1st
2nd
3rd
4th
—
• Future Connection Openings
New Fixture, Old Openings
Connected with
Sewer
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ......................
x $1.50
$ d
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ............................
x 3.25
$
Water Heater (Up to 200,000 BTU) ......
x 2.00
$
New Ground Run Old Bldg. ............
x 3.25
$
GAS FITTING FEES:
NO. RATE
1st 3 Fixtures ..........................
x $1.50
>TOTAL
$�La
Additional Fixtures ....................
x .50
$
Gas Range to 200,000 BTU ..............
x 2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE $,I -� ^
0
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 correct.
rridley, Minn '�Z; 190
Owner
Kind of Building
Used as ! 1I
n
To be completed about
Estimated Cost, $ v z®�
Old ew. uilding Permit No d Permit No�
Signed 4
By
Business Phone No. e
ROUGH 1 – )� 9 `r l 4
FINAL
01
SUBJECT
PER
City of Fridley
® 178i5
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEI
COMMUNITY DEVELOPMENT DIV.
INSPECTION
/O/76
r � � PROTECTIVE SEC.
1 = �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
`•"'� � ,'� 612-560-3450
910-F15
1/22/75
JOB ADDRESS 7325 University Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
19
5
1 Melody Manor SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Erland C. Thor 7325 University Avenue N.E. Fridley
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
NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Constaq-:1at 241 1
Garage
a 3E
9 CHANGE QF USE FROM TO
STIPULATIONS Provide a hard surface driveway, by July 1, 1976.
SEPERATE PERA41TS
REQUIRED F OR �iiREtVs�.
HEATING, PLUMBING
ANd E
S 01���,
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
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
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
0.2
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
$3,312.00
1.66
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
F ERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$11.00
PLAN CHECK FEE
TOTAL FEE
$12.66
SIGNIV ACTOR OR AUT RIZED AGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
sry
BLDG. INSP DATE 7
SIGNATURE OF OWRWE4R(DATE)
01
STATE -17H. NP 16
SEFMC-E DRIVE
Al
LU"T
MO,
91"
66
1p
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STATE -17H. NP 16
SEFMC-E DRIVE
Al
LU"T
MO,
91"
66
cn
T-
0
rnil
owner of the property located
2.
have no objection to the City
allowing the construction of a �c 6'Cj to be located at
without the required certificate of.
survey that the City ordinarily requires for all w construction.
I
signed
Address
1 - `-�- - --'-) 5
Date
Qla�-"'�Zeo
Ritness
APPLICATION FOR RESIDENTIAL, ALTERATION.-
OR
LTERATION;
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME : _ �; ai,"ILDER :
ADDRESS • 11 3 5 0\AU kluj—ADDRESS:
NO:.NO:. 3 C -A'S STREET
LOT :L 9 BLOCK:_
Due
INSIDE LOT:SETBACK:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To Be Used As:
DESCRIPTION OF BUILDING
Front: Depth: 4 Height: Q
P. U -
Square Feet: Cubic Feet:
Front: Depth:
Height:
Square Feet; Cubic Feet:
Type of Construction: AWL/)�*tima.ted Cost: $ ` ,�� U C;
To Be Completed:
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.
DATE: I SIGNATURE: �� v
(See Reve se Side For Additional Information.)
e F�
BUILDING PERMIT FEE SCHEDULE
SECTION 2. 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:
UNIFORM BUILDING CODE: Type 1, 2 & 4 $2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
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 six (b) inches below the floor line of the basement
or the cellar to the average heights of the upper surface or to the averages
-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 forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE: Permits for construction will be issued a minimum of 24 hcurs from the
time of application, to allow for proper review of the proposed structure and
of the construction site.
A Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceeding with the framing.
CERTIFICATE 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.
♦,
c
a -i
1
♦,
c
01
SUBJECT PERMIT
city of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
' COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
"1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF APPROVED BY
612-571-3450
910-F15
7/9/79
JOB ADDRESS
7325 University Avenue N.E.
1 LEGAL
LOT NO.
BLOCKT
TRAC OR ADDITION SEE ATTACHED
DESCR.
19
5
Melody Manor SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Erland Thor 7325 University Avenue N.E. 786-9722
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Leo Sanders 7813
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install drain tile
9 CHANGE QF USE FROM TO
STIPULATIONS
SEPERA►TE "PERMITS REQUIRED WR WIRI G;r
cmATING,TLUMBING AND SIGNS.
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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,500
$1.25
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISION F ANY OTHER STATE OR LOCAL AW REGULATING CON-
STRUCTIO R THE PERFO ANCE OF CON CTION.
$15.00
PLAN CHECK FEE
TOTAL FEE
$16.25
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGEN (DATE) o
WHEN PROPERLY V LIDATED THIS IS YOUR P RMIT
/f
D /
BLDG iNSP '114
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
01
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OWNER:
ADDRESS:
TEL NO:�-
STREET NO: +
LOT: Iq BLOCK: ADDITION: ����u�}�lO�
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.
STREET:
ADDRESS: %:..�_-_:rte d=.'
TEL NO:r , i
Construction Location
DESCRIPTION OF CONSTRUCTION
Front:
Squane Feet:
Depth: Height:
Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: ��zsL 4
Estimated Cost:
To Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
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 ar)�7true and -correct.
DATE: SIGNATURE:
Stipulations:
t.�
BUILDING PERMIT FEE SCHEDULE
SECTION 2. 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:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x Y15®75
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 r. $17.85
W.110132 211alftfir.1111 K11
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 six (6) 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 ]aer each five hundred dollars -($500.00) or fraction thereof in the cost
of all proposed work.
In•no rase shall the fee charged for any permit as set forth in Section 2 be less -
than $7.50 plus $.50 state surcharge.
.VERIFICATION OF FOUNDATION
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.
Rog iIng mg I WSJ wn
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.
susiEti
ERMIT NO.
City of Fridley
31916
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
16.
DIV.
______ COMMUNITY DEVELOPMENINSPECTION
512
RECEIPT NO.
r � L I PROTECTIVE INSPECTION SEC.
1 � T
NUMBER
REV
DATE
PAGE Oi
APPROVED BY
1 0. '% CITY HALL FRIDLEY 55432
612-571-3450
910415
6/20/01
JOB ADDRESS 7325 University Ave NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
5
Melody Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Steven Petschel 7325 University Avenue
NE
763-784-0038
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
O NEW O ADDITION 0 ALTERATION j] REPAIR 0 MOVE 0 REMOVE
B DESCRIBE WORK
Reroof Duplex (24 Sq) Tear-off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with
the State 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 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
2
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
$2,454
$1.23
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOT FEE
1-11
/
. $86.93
S1GNATU OF C014-RA TOP T iDATEt
EN RDP
ALID T THIS IS YOUR P
r
MIT
NATURE OF OW NEPOF OWNER GUILDERS IDATES
BLO NSP
- GATE
NEW [ ] Effective 1/1/2001
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: _ j 3 Z S;
Legal Description:
Owner Name & Address: Sp -ed Is N Pr' TSC mcc--'L Tel. # ;7 (,3 - > S Y-00 3 b
Contractor: 5-e, t C— 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 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: $ 01 �y
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: (P –ZJ– o / APPLICANT: Tel. #
CITY USE ONLY -
-Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$ .�. Fee Schedule on Reverse Side
$ .2,,V � .001 of Permit Valuation (1/10th%)
$ C-,23 $.50/$1,000 Valuation
$ $1150 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 [ ]