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PRE 2010 DOCSVillage of Fridley, Minn. BUILDING PERMIT Date: .... dt?!/.... �.z... .. s a....... Owner....................................... Address...................................... No 1769 Builder .. � � . ........../"C. ..... �cl .. L`.. . Address ... �, rA t� .... �F! a ............. LQCATION OF BUILDING No . ��..... Street ... � !�. r9 ��.... .1.e.......... PartofLot ............................. Lot ...I ........ Block ..... �.......... Addition or Sub -Division �J� �? 9° 2.! . � /"0 4 <? � �'• Corner Lot ........... Inside Lot .. ... Setback ..�3A .... Sideyard ....� d ..................... DESCRIPTION OF BUILDING To be Use s} as: .jv .... !...!... ?j..... Front .. Al .. .. Depth ?. .... Height . '... Sq. Ft. ?�� . ! Cu. Ft. ........ ..................... Front ........ Depth ........ Height ...... Sq. Ft. ........ Cu. Ft. ........ Type of Construction ...... Est. Cost ...' ............. To be Completed .................. In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the village of Fridley. eJL %' ............................................... In consideration of the payment of a fee of$ hermit 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 village limits and this permit Ahay be revoked at any time upon violation of any of the provisions of said ordinances. .................. Building Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. City of Fridley, Minn.. BUILDING PERMIT N°s =Q9 kgner Builder Address Address TIO F UIL ING Street Part Lot LotBlock Addition orSub- on .' of Corner Lot _ Inside Lot _ �rtback Sideyard Sewer Elevation _ roues tion Elevation DESCRIPTION OF BUILDING To Wd as: Front _ Depth Height Sq. Ft. j Cu. Ft. Depth17ight Sq. Ft. Cu. Ft. Type of Construction Est.Cor;00 4F 4F _ To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above ,.set forth and ;in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $A 0"i""`""" ,,permit is hereby granted to te ess condition to construct the building or addition as described above. This permit is granted upon hexprthat the person to whom it is granted and his agents, employees and workmen, , in all work done m, 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 dty ]units and this permit may be revoked at any non viola of any of the provisions of said ordinances. Building Inspector NOTICE: Thb permit does not cover the construction, Installation for wietng;' phnnbing, g•s' healing, ower or crater. Be sore to see the Building Inspector for soparate p•rmhs for then hams. e A APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner °s Name Builder ®�w Address// J - �`-�� Address LOCATION OF BUILDING No. �� street ,4___,"art of Lot Lot Block44Z Addition or .Subdivision ' Corner Lot Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To b used as: Front o� Depth o —u Height To / U Sq. Ft. ��� �✓ Cu. Ft.L a � Front Depth Height Sq Ft. Cu. Ft. Type of' Construct io`n�-�,% Estimated Cost 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 / ���% SIGNATURE'. Tr----- (Schedule of Fee Costs can be found on the Reverse Side). C BUILDING PERMIT FEE SCHEDULE Section 2. The Inspector of Buildings shall, before issuing an pert for the erection of any building or structure, or for any addition toanyexist- 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= For any such permit for the erection of any fire -proof building, other than a garage# warehouse, factory or grain elevators 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 - per $1.00 for each one thousand cubic feet. GARAGES 2-A. For any such permit for the erection of any non -fireproof garage, warehouse, factory or grain elevator, or for the erection of any non-fieproof addition, for similar occupancy, to any existing builds building or addition - ninety cents ng or for each such et or fraction thereof, in the cubical contentsthereofwithone ta miannimum of c $ 4.00. For the purpose of computing fees for building p of any building or addition to a uniform -height throughoutebyumultiplyingnthe ground area covered from a 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 patched 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':.fee charged for any permit as set forth in Section 2 be less than $4.00. August 27, 1962 TO WHOM IT MAY CONCERN: This is to certify that we, the builders, do take full responsibility for the foundation on the garage at 118 Ventura Avenue N. E. for the period of one year after the date of completion of said garage. During this time, should there be any break-up or deterioration of the foundation, other than from natural causes, (this shall be decided by the Building Inspector), we shall at that time rebuild said foundation to the satisfaction of the Building Inspection Department. Yours very truly, � (L(� I NORDCO,'J INCORPORATED Date: _ AUGUST 20, 1965 M. FRETTE Builder DONCO, INC. N® 8393 Address 118 Ventura Avenue N. E. Address 1052 Osborne Road N. E. Fridley 21, Minnesota Fridley 32, Minnesota LOCATION OF BUILDING No. 118 Sit VENTURA AVENUE N®E. Part of Lot Lot - 9 _ Blocky Addition or Sub -Division _ Carlson's Summit Manor, North Addn. Corner Lot — Inside Lot Setback — Sideyard Sewer Elevation Foundation Elevation To be Used as: Type of Construction DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height ._ Sq. Ft. Cu. Ft. Est. Cost $5, 000, 00 To be Completed REPAIRS DUE TO STORM DAMAGE In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above se rth and in comp ce a'il provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $_1QaQQ , permit is hereby granted to DONCO. INC, to construct the building or addition as described above. This yrmit is granted urn the express conditi�att thdworkmen, in all workLdarounaupon d building, or anyy part thereof, shall conform in all respects to the ordinances of Minnesota location, construction, alteration, mmaintenance, repair and moving of buildings te city limits permit may be revoked at any time upon violation of say of the provisions of saidcxs. ALLEN G, JENSEN Biding Inspector NOTICE: 116 permb doss not eavar the eoeshuedon, iastdWan for whbg, pi n Ains, gas hsaHnp, sawar or water. Be sure to no tho SWIdteg lespomr for sopmft pennih for these Maas. APPLICATION FOR BU31DING PERMIT CITY OF FRUMs Mj*ESOTA OWNER'S NAME `//� � ® `�' ADDRESS / �- C—Q ADDRESS LOCATION OF .BUILDING STREET �� a �/� �`�`� PART OF LOT ON OR SUB DIVISION LOT BLOCK ADDITI - CORNER LOT_— LO SETBACK FOUNDATION ELEVATIONSIDE YARD T SEWER ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING int Depth _ Height . Ft . cu. Ft.— it t.__lt Depth Height ----- YP Sq. Ft. Cu. Ft— Type t T e of Construction Estimated Cost ® ® � To be completedq b v 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 rulingsof the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. ,0, DATE / �IGNATURE - (Schedule o Fee Costs can be found on the Reverse Side). APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEYt MINNESOTA rwoovl OWNER'S NAME D d 'e4K' %�� BUILDER �'�✓���� ADDRESS Noer, ADDRESS LOCATION OF BUILDING NO �/� STREET PART OF LOT LOTBLOCK ADDITION OR SUBDIVISION G2���- CORNER LOT INSIDE LOT k -__SETBACK SIDE YARD SEWER ELEVATION FOUNDATION ELEVATION 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 Height Sq. Ft. Cu. Ft. Front Dept h Height Sq. Ft. Cu. Ft. Type of Construction_ Estimated Cost 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. q DATE ✓ SIGNATURES (Schedule o1PFee Costs can be found on the Reverse Side). d � BUILWWQ f? ;R'LF. FEE SCHEDULE SECTION 2, The Inspector of .Buildings Ahall, before issuing any permit for the erection of any building or structure,''or for'any addition to any existing building or structure,.or for any alterations or repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such permit :-of `fees' tbo. 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 $l AO 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, n warehouse, factory or graielevator,'6r for the erection of any fire -proof addition, for similar,occupancyf,to.any existing building shall be at the rate of $1.25 for each one thousand cubid"feet, classified as "fireproof" by Section 502 of the Minneapolis Building• -Code. HOUSES 2.3. For any such permit ;for..Ithe erection,'.,bf- tiny 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 -fire -proof addition, for similar 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 the 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 a point six (6) inches belooa 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 fee charged for any permit as set forth in Section 2 be less than $4.00. STORM REPAIR DAMAGE PEES: Residential; Estimated Cost of work up to $500.00 - $5.00 Estimated Cost of work over 4t500.03 - $10.00 22rv3nercial; Estimates ist of work up to Y5e^0c00 - sir i Estimates ast of worse over $500.00 - $`l. J `. •.- City of F►idley Application for Pkmbkg and Cas Fining Pwmk Dept. of Bldgs. Phone 960-3430 52-84-079001. DESCRIPTION OF WORK Number, Kind and Location of Fixtures Locathm 118 DTE. Venture Ave. O < Number Fixtures ................ , 1, ; < ei 1 $ Future Fixture Opening ............ x $1.50 $ - New Fixture Old Opening .......... ► WATER "U. N GAS ELEC. Catch Basin .................... x $3.25 $ Soil i o x $3.00 6' 33 3 (3aZ u� Electric Water heater .............. a $2.00 Base CTAS 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 range 3.00 REPAIRS & ALTERATIONS—Refer to Code Description ............................................ - TOTAL FEE $ 3.00 2nd 3rd EH 4th . Futuro Connecdon Openings Com With } New Fixture. Old Openings Sewer CUSPOW °a PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ 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 $ Electric Water heater .............. a $2.00 $ CTAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ............ • • • x $2.00 ¢ Additional Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU ... ,...... , ... x $5.00 $ Replace (1) gas range 3.00 REPAIRS & ALTERATIONS—Refer to Code Description ............................................ - TOTAL FEE $ 3.00 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 aR the fact and representations stated in this application are true and correct Fridley, Minn July 12, 1971 19 Owner V. V- Ru jokes Kind of Building frame Used as residence To be completed about July 16y 1971 Estimated Cost, OldZNew. Building Permit ROUGH Mass "A"Surcharge .50¢ YY Business kne No SUBJECT Reff .IT" N0. City of Fridley _ 19232 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. I °16.0 ___ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 10/7/87 JOB ADDRESS 118 Ventura Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 4 Carls.on's Sumit Manor North Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Victor Butkes 118 Ventura Avenue N.E. 572-1004 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton L. Johnson Co. 2513 Central Avenue N.E., Mpls. 55418 781-9548 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 I� REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install. aluminum soffit 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. 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 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 $17700 $.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 O ER STATE OR LOCAL LAW REGULATING CON- $ 28.00 STRUCTION OR THE P R ORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FE o 4� 4j7 $28. $28. 1 SIGNATu EOFCON AC OROR AUTHORIZED AGENT 'DAT' WHEN PROPERLY V ID BLDG iNSP TED THIS IS YOUR PERMIT ATE SIGNATURE OF OWNERUF OWNER BUILDERi 'DATE' NEW [ ] City of Fridley Effective 14/1/86 ADDN. [ ] �R-1 AND R-2 ALTER. [ ] Building Permit Application Const ruction Address: / l V "" L x-14 YT e1 _ Legal Description: �Owner Name & Address: �s Tel. # �� .'� ��c�® �-� Contractor: Tel. # V-� �� Address: S`/ oe•p d C_ Ap 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: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback 4A110 �' I ° �c Estimated Cost: $ �a Type of Construction: f Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation DATE: 4' APPLICANT: WIL Tel. - S CITY USE ONL Permit Fee $•OQ Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ RS $•50/$1,000 Valuation SAC Charge $ $1475 per SAC Unit 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 Valuation Fees $1.00 to $500.00 $10.00 (Minimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000. $2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000. $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000. $100,001.00 and up $433.00 for the first $100,000 plus $2.50 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 been -constructed will be required before proceeding with the framing. SUBJECT MIT NO. City of Fridley 27596/ AT THE TOP OF THE TWINS BUILDING PERMIT Ir �T NO. �` _.___ COMMUNITY DEVELOPMENT DIV. ~ I PROTECTIVE INSPECTION SEC. r � , CITY HALL FRIDLEY 55432 �`� NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/8/98 JOB ADDRESS 118 Ventura Ave. NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 4 1 Summit Manor North SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Anna Butkes 118 Ventura Ave N.E. 55421 572-1004 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. R & B Construction Inc. PO Box 70 Cedar MN 55011 434-1206 20072653 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 0 NEW O ADDITION O ALTERATION REPAIR D MOVE O REMOVE 8 DESCRIBE WORK Reroof house & garage, (27 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 $2313 $1.16 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE $74.75 SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- Fye SC $2.31 TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TO FEE a '21K Licens $5.91$83.22 SIGNATURE OF CONT RACTO OR AUTHORIZED AGENT IDATEIEN R B G INSP Mlj/�y� VALID THIS IS S11A IE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW [ ] Effective 1/1/98 '' ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: / i vee) T" Ora AvE- Al Legal Description: Owner Name & Address: 14AIAJA F6u-rxF—.s CSA rA E� Tel. # S-72 — 100 `i Contractor: 1- e0n1 S 1 rz UcTea �I C , ,ns �, e MN LICENSE # �� 72- C3 Address: ft, 40x -70 6WAIL, /y9,v s O) I Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: S $ CU CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ ] 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: T ,®a-- o �p�-- 12F-- Roo -F- h)p Lj s e 7 �,3 1-3 Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE. %k9e APPLICANT.. �a,; ,�� , ��r '�� Tel. # gel -1Z46 7 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: S $ CU CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ ] 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.