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PRE 2010 DOCSOwner Architect Fridley, Minn•,. Builder,"�"� 'I LOCATION OF BUILDING . No.Street Part of Lot Lot 'Block Addition or. Sub -Division i ji DESCRIPTION OF BUILDING Front Depth Height_'Stories anner of Construction To be used as To be completed Estimated Cost120, Permit is hereby grated to the building described in a above statement. This permit is granted upon the express ndition tha the person to whom it is granted, and his agents, employees and workmen, in all the work done in, ajound and upon said building, or any part thereof, shall conform- in all respects to the ordi- nances of Fridley, Minn., 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. of Buildings. ii 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 hereby state and say that the facts stated by me and contained in the abov permit are true as therein stated. Subscribed and 'sworn to before me at Fridley, � day of .."yam, A.D. i9f i CITY OF FRIDLEY Effective Aug. 1, 1961 APPLICATION F014 RESIDENTIAL BUILDING PER141TS (New, Alterations, Additions, or Repairs) OWNER: � BUILDER: 1.- aA ADDRESS: , � 4o - ar'O'_ 6�- YV� ADDRESS: TEL 110: Z -17 D TEL NO: 7 Z - J I� Construction Location • STRtTrT NO: L'A-0 STIMET: 6f- I'lVe LOT: BLOCK: ADDITION: 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 IM�s �l$I Front: Depth: Height: Square Feet. Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: Estimated Cost: $ _ (n® Tb Be Cbrspleted: Alt. A Alt. 8 Proposed Driveway Width If New Opening Is Desired: SEE REVERSE SIDE OF SHEET Tire 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 DeZkcirtment of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. UWE: Stipulations: ,5.0 cp •— CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Effective On January 1, 1991 Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 ' REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Re idential Furnace Shell and Duct Work, Burner - Also Replacement Furnace /.Gas Piping (Needed with new furnace) Gas Range Gas Dryer Rate TOTAL $ 20.00 $ a �� $10.00 $— $10.00 $10.00 $ *Air Conditioning - All Sizes $10.00 $ All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ CommerciaUlndustrial 1 % of Value of Appliance or Work $ State Surcharge $ .50— TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE ' REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and ruling of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. ! ,1991 OWN BUILDING USED AS om-e— ESTIMATED COSTPERMIT 1111,19 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units I Circle One (Steam) (Hot Water (Warm Air Trade Name +&gK s&&e' ,�� Phis Size No. 10�U BTU o'er- HP �' Abeam EDR Fuel Total Connected Load IS 51gAAJ1 u Burner Trade Name ynp Size No. A-Z&ODMAJO& % BTU :0441 HP i IntextieIr EDR HEATING COM Signed r" Put U, - FILL OUT BACK SIDE FOR STACK VEFI-FICATI ON REPLACEMENT FURNACE N'll "c ft� MA CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes ( ) No ( ) 2. Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes ( ) No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's List Alterations Being Done: HEATING COMPANY Signed By Date SUBJECTR.-�-__ City of Fridley 213 4 AT THE TOP OF THE TWINS BUILDING PERMIT O COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. NUMBER REV, DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 ILA .; L ---- J` 612-571-3450 910-F15 5/20/92 JOB ADDRESS 4540 2nd Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. A 6, 5 13 Plymouth SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Greg Miller 4540 2nd Street NE 572-1708 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 52 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE Q REMOVE 8 DESCRIBE WORK Construct a 301 x 26.1 2nd Story Addition to Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan SEPARATE PERM`S. R1het) r6R WIRINGo HF.AtINOj PLUMOING AND TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. 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 $41722 $20.86 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- $362.50 Fire SC $41.72 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $425.08 JAGENT +� IpD�ATEI [WHER SIGNATURE O�F(CONTRACTOR ORAUTHORIZED 1{///1®�f/�'/,il�l� �i U �/ AL1 �•/oL-V �'�x.✓'�y LY V L�J ED THIS IS YOUR PERMIT P �a7E SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] ADDN [YJ CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 1A �54I Legal Description: 7�- N , *-(,o Effective 3/1192 Owner Name &Address: ree,� ���ar q5y© /VE Fr Tel. # v 7a-1?®'� 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 IMPROVEMENT LIVING AREA: Length 3D Width ��, _ Height $ r GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: Sq. Ft. 7,'Q Sq. Ft. Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: or., n- a Estimated Cost: $ Approx. Completion Date: 3 1193 7eC9 '3.11? = -IL `172 2— (Cost on Back) Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x $ = $ DATE: APPLICANT: 'Itm AZ` -/i4-, _ Tel. #v�®2 -%%3 ITY USE ONLY Permit Fee $ 3L2 -,S-6 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1 / 10th %) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $700 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $®� STIPULATIONS: 0 E�s�timat .� . Estimate From �'FOr: i"L' r%l� P' 1395 � SS ti 57� /70-Y, _. Store Location: " �!`• /c�� Job Location �1}� Page Of DATE EST IM D B ESTIMATE TYPE PRICES GOOD THRU a N k QUANTITY SIZE LENGTH DESCRIPTION "' FEET PRICE U/M AMOUNT 16 5 -PIC FJ Sp, �vsK `x - 3 X� a ' �f ek 'YFh .� ,{"I• F e02 'yyt klF'4 $a +4 ''- :.' y{! Y +I 1 1' y/� �/ 4y 5, y Gf ... All e4y .rp'f �,Q1'�i Jy4f� •. �' iyY �E V { "I ., �.aAL'��knJ1i%dZA -'..`2.* I �Y..'' rte' `.� '�'� F �" t �`T':P',�y'. X53 '4 Y } .:�• �d 4a y F ''mYiNt Y+Y'l P,' J�ir't�... >• i�F' . ��. «y �1 j 5 '§ SRa:�=�' ` vi y F: ti,•t 9... .. 4:. � J'.+. a*r.'�'��' t?: �.�' `� �k "3 i. � f '9 a'�'' '..� �.E 4 Am ' ` Yi^7�'4W.b iiL .: 4 'ky ka,��y :• 1Y4� yii' j .y..� jf�k i^ ti�4W'U n. .^t:,. �'#.M 4{-{y,�� i -i :. 1.c '." f '.', r Ld3' +'Ss$.:. 6, 'b✓' b y+,sd'a^ Y Y t$Ij �7'4� X' 3` 1 k f^•1"'rJ+ f f�' t i ���a�zh'�i A ^5 t� , T. : �..� ,gs�`ba�.•'ri � � rE� � `.:;- ^ {y�. r.'e-0 __ A. fv��„' {i "4�' C S '�V'�' Y' '� § 7'� T � i^'A�f � (, ! w/� �• Y 't "pH, Ny - .'F J ys r 1. 4 .. } _:,':�'.q S� ..:.. ,ry.,J.• Y , S .? � >T' . '! . fk � t �,'�a�`��' �'i .'��♦.((� '.i� \ #d�V/yA' Y 4 �"� $, n Mt'P!y 78+:,. »Y, °" •, h tr' ..'�'bj ,*�'�:� .�yr,i-f"`i` .i F,.,�py#�' •Sr,{;F,4 -�.�.0 :R& +a'n �Y ha: F � ♦u' �L ':'aY.t C'M1� y, � � '�� aft �:: t � ,A?ri `-;�+�i'��A���.V�„ � �;'vY �44+'4A'.i-?i �q����-i I 4 ,?�� s.A:��-• � `,yf_:.Y^ �:'j.'Pl r' tv ' W '% P - 1 J Yni �i13.c�hi��� yv .4 34±�'i "hn� � �s�� Y RF � 5 tC �{.F�4 � -S "i � � i1 e� �11�a. �• 17 'Ri 14 39 This Is an estimate. It Is given only for genera! price Information. This is not an offer and there can be no legally binding contract between the parties based upon this estimate. The prices stated herein are subject to change depending upon the market conditions. The prices stated on this estimate are SUBTOTAL - not firm for anytime period unless specifically written otherwise on this form. The availability of materials Is subject to Inventory conditions. kENARDS 1_0 Z11, -1S NOT RESPONSIBILE FOR ANY LOSS INCURRED BY THE CUSTOMER WHO RELIES ON THE PRICES SET FORTH HEREIN- OR ON THE AVAILABILITY OF ANY OF THE MATERIALS STATED HEREIN. All Information on this form, other than pHce, has been provided by customer and Menards is not responsible forany error* In the Information on this estimate. Including but not limited to quantity, dimensig n and qual ty. Pleaseexamine thla estintsted:arefully. MENARDS MAKES NO REPRESENTATIONS, ORAL; WRITTEN OR OTHERWISE THAT THE MATERIALS LISTED ARE NV�C Vr_A � REPRESENTATIONS THAT THE MATERIALS LISTED HEREIN MEET YOUR CODE REQUIREMENTS.'.:'' 1k i CUSTOMER -COPY DATE ESTIMATED BY ESTIMATE TYPE PRICES GOOD THRU 3 f" OUANTITY SIZE LENGTH DESCRIPTION FEET PRICE U/M- AMOUNT Al C-a�,� y93� �� �� �� � �.� ��� �} �' ®t F 4- '�'--sir`_.`;.-'`' r �Y x,. •`�` � ) } ":4 _' � = �.�..�� ' J A�pprr � � �� 1 I : ..�- +lit � 4 11�,c iA.t,.._ 9yu N�+,.Vt".; ti s..j� x �// --*�i�..-'tt�fr°3:%�,`��.. h7u'�� '�S� Th4.x. � ii�� 1S^ �� _:���'9✓�,;(�\ c'.5 ..:�� ::: =1 -�l uWj<+ 3..d`�.�•F t :x ;S f.Tt r `�+'�ifE'� ?� e?'. .� '`i,,p �✓J� 9 "411 � ���F, 7, k ��.M1 . ✓}( aGl� Ji a�JX1^ ? p t'w t Wr.�"A '4 !3: `,F„, C._ ' -. w,y �.Nt-N . ;, �'° �' �.nt d t s T`',j �•�'�,5.�""� � h' ���}. '�. 't 6 1 r b 4. 3 �, -:,F �. � d.•`.f" t.n ,7. _.n k Y, t r`'iyt`'4 Yt ry J � .y � ✓ ld} ` . •``� r f 1�� � '1' V � /yvkr`� ff__ 4 �x M . ;.,`Yyy"�`$°sd. _ 'l'.3U�'C '`' W' ��� !u , � f 1' �'� r6 t` •'fit �( W 'S+��..C {)£:'111�, 2i�o •'} Y K lr 4.t' .: -�.-Y t��i'a V17e f 't%`FY'� ZiIM t Sf L �u/ `, Y. �Y k�� �' h 1 K t7� � � 1 ? eol b tisr' This Is an estimate. It Is given only for general price Information. This Is not an offer and there can be no legally binding contract between the parties based upon this estimate. The prices stated hereln are subject to change depending upon the market conditions. The prices stated on this estimate are SUBTOTAL not firm forany time period unless specifically written otherwise on this form. The availability of materials Is subject to inventory conditions. MENARDS IS NOT RESPONSIBILE. FOR ANY. LOSS INCURRED BY THE CUSTOMER WHO RELIES ON THE PRICES SET FORTH HEREIN OR ON THE AVAILABILITY OF ANY OF THE MATERIALS STATED HEREIN. All Information on this form, other than price, has been provided by customer and Menards is not responsible torany enois in the information on this estimate, Including but not limited to quantity; dimension and qusllty. Please examine this estimate carefully. MENARDS MAKES NO REPRESENTATIONS, ORAL, WRITTEN OR OTHERWISE THAT THE MATERIALS LISTED ARE SUITABLE FOR ANY PURPOSE BEINO CONSIDERED BY THE CUSTOMER, BECAUSE OF WIDE VARIATIONS IN CODEST THERE ARE NO ;F h y,ra Zt�REP THAT THE MATERIALS: LISTED HEREIN MEET YOUR CODE REOUIREMENTS - 7 y�r; : 4 CUSTOMER COPY Job Location _ Est�imate�From �.' �F Store Location:i���, Page—3 Of This is an esBmste It 4 gfveh only for general price information. This Is not an offer and there can be no legally binding contract between the parties based upon this estimate. The price's stated herein are subject to change depending, upon the market conditions. The prices stated on this estimate are SUBTOTAL not Rrm for any time period unless specifically written otherwise on this form. The availability of materlala to subject to Inventory conditions. MENARDS IS NOT RESPON8IBILE,FOR ANY LOSS INCURRED BY THE CUSTOMER WHO RELIES ON THE PRICES SET FORTH HEREIN OR ON THE ' ? ` AVAILABILITY;OF'ANY.OFFO;E MATERIAL8'.STATED HEREIN. All Information on this form, other than Pike, has been prodded by customer and x•,, : �.', > 4 Menardsbnot.responsi t*anger6tatnV*InIormatlonon this estimate, including but nottimitedtoquantity,dimension a dquagty.Plesseesemine Ihb'estlmafe'7earofuSy: MENApDS;; MAKES"NO REPRESENTATIONS, ORAL, WRITTEN OR OTHERWISE THAT THE MATERIALS LISTED ARE ; ' `i3UITABLE FOR ANY,PURPOSEBEINQ CCNStDEREQ 8Y THE CUSTOMER; BECAUSE"OF WIOB VARIATIONS tN COOES,;,THERE ARE' NO ( N;? axr tP '3 npw y. REPRESENTATIONS THAT THE UATERa,W,USTED HEREIN MEET YOUR CODE REQUIREMENTS.- D E ESTIM ED BY ESTIMATE TYPE `� PRICES GOOD THRU _ QUANTITY- SIZE LENGTH DESCRIPTIONS FEET PRICE U/M AMOUNT. % 04 77 Aloe - Z" .: y So 9 N4 101 uNr..rPq� ^' ��jq�� ��%it' � i'�p .i. - t� :� i���• q�''l'ltlj,O�"'"��� Ti'' - .� f � S,<. �Il�;m .iiJ„T 3 LI"�F >,),. M�'c k ♦ _ h_ ^ v.,. 1 g�ha:r - p� 11 P � ' ay�„c� � ���i `'t� »• 3- °�'`'i'h�. ,i , .� : _ §' 3�,.,� § g3 � 1�'T �',� a� > �„ � �r� r�` , ar �, � ,.•?tea a * ,� � - '/"• ?YM U st c. b'b .v. '3�.. y � z ��� -F�."``�,� 1. 5•� ck` �.4x'.f '.��ji'N�� �A•�' a s'a 's : 33 _:S� Y�S��3u '`'�u` � �' -J -.� i -fp1. J. ,h ".Art. .�•. "4fi�.. ...4•n37„ � f7. 41 ?i' - �� Y � �ti '�� 3 J`1y_`�,yd•�- � J-y,}�,�'K. -'. L4<-�` �' ii-i"'Y`4AT`.�1 . iy}1i�' A . t Y .k'�i hi R•.Ev%'$' t vv � j.GS`L'r k� $t ���4 .y1 kAayi N'+yf �r�� •.i f %� ')..,J 'F .Y .7 �'`�t:Ta ise,�i y i R4 9 Gf .. '{ '�' '.� '.% 4 !YSuF_ ; ub .. �yi+J.f • S'S._4✓iJ� 1 $,Si '•� c'' l'�M 'Ai.R,q J'} -' 1 % a'E� �t ����?°tit �?nY _',5--<���''...9t'a9` ^+t: ... ,3Y k^�p. _..;�.: a.... �� �. ..-:a�,��s��,::r t�,�k+�>..,?.,�a� '�i:•��- -. *�'};Z;x:.x3 �$�:.�'6�n ,1,i (`�-�.J _;ir _ r •F w -C: �4 - � "�'R -vi. � <etcvt, 'dvy�3����� �k-, y6���b��t , .; �.,, 4R R�,'�,„���Y. 4f � •{ �3� Ytt' n ,d r. b" Rt -: a ..., . i�«,t k Y. ii `.3���i�$-.ts "����`.:...: 5°`. ` ,. .. �:'. a�..-��.: 'S ..::r'+n .�..�,.. - ; t',�". �.a&r.... '^� ,�S}':• __�Y,.s,`� A - Y ����� 5��� �` C-?"�w�� •� �YFiK ���`•�+D ` 'S� , i. >t ,e��fi��'P�}}S� 4 {� �'Sv"_. ,^ yyK .. 2^ •Vc 't- p f" ! E.�i i� � d X74 +{' �'�' 3 f 4{ a3;. �' �h',,:• 4�? d- y1r" 4 ;(' • ?-�+•'�t `�,i :'3P ` �4 L � �M 9 � '>.,;\ 3 _.,�z "� ry aµS }Ri �".< . P � i'i4 X 2 p'' �^ }�- - ii �i"v�-. k` ii .. :'-� � _'t� ,�•�t �h i _... i. 't1',9 J.h�J �y�f � �• ••f� j1 1��y,'Y�,,r��'` � �i'•j�{ 4 t�"+'f .,i,w �tq�^�'i> •P%'.4 'q� �... "" 1t 4 =� - � I'�h "� - .R. 43t � i � �C�c 1X `fir ���+£2�''Vf��.�lj4u.,'%i 4�.� x' k� �� ,�, '4 �,,�' L�.f vtn v y.. � ,�- ,�'1fJ.'-T^y?'•$-nd`K �•'. � {`=t �{ ae'o Z72. +'�`��"�i i'�g., "fj ..v,'.4yY ��'� � � i. � Y: �'�2P . jJf 1 �.� � S7 �k h {.'G �. S� �..f„ j.;3 � � -r�,,. to 'ri�r1 a �tz,.e, 3'�i?y'„ � �a ��' D 3 }X*y u'Ir�, .�� s. - .. `• e' This is an esBmste It 4 gfveh only for general price information. This Is not an offer and there can be no legally binding contract between the parties based upon this estimate. The price's stated herein are subject to change depending, upon the market conditions. The prices stated on this estimate are SUBTOTAL not Rrm for any time period unless specifically written otherwise on this form. The availability of materlala to subject to Inventory conditions. MENARDS IS NOT RESPON8IBILE,FOR ANY LOSS INCURRED BY THE CUSTOMER WHO RELIES ON THE PRICES SET FORTH HEREIN OR ON THE ' ? ` AVAILABILITY;OF'ANY.OFFO;E MATERIAL8'.STATED HEREIN. All Information on this form, other than Pike, has been prodded by customer and x•,, : �.', > 4 Menardsbnot.responsi t*anger6tatnV*InIormatlonon this estimate, including but nottimitedtoquantity,dimension a dquagty.Plesseesemine Ihb'estlmafe'7earofuSy: MENApDS;; MAKES"NO REPRESENTATIONS, ORAL, WRITTEN OR OTHERWISE THAT THE MATERIALS LISTED ARE ; ' `i3UITABLE FOR ANY,PURPOSEBEINQ CCNStDEREQ 8Y THE CUSTOMER; BECAUSE"OF WIOB VARIATIONS tN COOES,;,THERE ARE' NO ( N;? axr tP '3 npw y. REPRESENTATIONS THAT THE UATERa,W,USTED HEREIN MEET YOUR CODE REQUIREMENTS.- dot st�t bo, �C' 7 �j 40� v 4540 etc , X� m 5s4 N S-tac Floor aLa . %,t = 1'01. a -►4 � �l6 2�I,TQ.P',o^ wall 36 This Pan Mtjst Be N'llaintained A7d Accessible On The Construction Site P C '0 N i Y bA! L I' STORE 114 AN A3'PQ0VED MANNE_h' KkU(�'f ALL REFUSC V KI. " Q_Z F-IrRat"E. ST0,FFNPPMV3 Penetrat;ons Riru valcld P -Ind IN0,01-8 sn-r-!N UP - sealed -.wil[h a ma-Zot: stDl of pro Ming, Ithe passage. of fianm_�swhell subjected to the recess erns` nl.*s Of Ito '.,*,--sl.' Standard specific for Fire Stops k3pl %fil-E-814. - - I V- o A, Gtee�, f�\-A4X% LI,5 9 0 --- ---------I I -- - ------- ----------- Fr Prn l'tr 1, 1 CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR New Fixtures UrinalShower Old Opening, New Fixture $ 4A0 Tray $ 5.00 FIoo: r Drain '.... ' Washer <' G s :'..:.:.: an eStories a erAuto. Water eWash ecR Gas EI $ 7.00 e e Bas t m n Rain Water Leader $7.60 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Floor 1 $10.00 %C); Gas Range $10.00 Gas Dryer $10.00 i Back Flow Preventer Required ( )Yes O No Type Floor 2 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or ApplianceSfJ State Surcharge Floor 3 TOTAL FEE $ 0 FI or 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 7.00f . Old Opening, New Fixture $ 4A0 Beer Dispenser $ 5.00 >; Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $7.60 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater -Gas �_ $10.00 %C); Gas Range $10.00 Gas Dryer $10.00 i Back Flow Preventer Required ( )Yes O No Type • $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or ApplianceSfJ State Surcharge $ .50 TOTAL FEE $ JOB ADDRESSD''IC� TIC,}( The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. _,1993 Owner ( ? � t E Building Used As 'P Lb ,1 Estimated Cost PERMIT NO. PLUMBING COMPANY-%"�'�.S{-�'� SIGNED BY TEL N0.),- P� Approved By Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 J S THE $50 ,SATE -SURCHARGE SUBJECT PERMIT NO. City of Fridley ��, AT THE TOP OF THE TWINS BUILDING PERMIT r • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 13 CITY HALL FRIDLEY 55432 �'' NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 5/8/95 JOB ADDRESS 4540 2 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5, pt 6 13 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Greg/Sharon Miller 4540 2 Street NE 572-1708 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 J7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 16' x 12' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 'II ARMNG Before digging call for all util'r� locations 454-l100i REQUIRE, By (.A TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 $•78 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,564 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- Fire SC $1.56 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION, $37.00 PLAN CHECK FEE TOTAL FEE $39.34 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PAOPERL ALIDATED THIS IS YOUR PERMIT V 611d" Y I r%r d✓ J ✓" J BLD INSP 6ai SIGNATURE OF OWNER aF OWNER BUILDERI DATEI NEW d 3 Effective 1/1/95 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application 1 Construction Address: �E Legal Description: J(— Cch$ c>f (o, gook (3 p (U ry10 add °h M Owner Name &.. Address.:. r d r ��k�f ')'�l: # Contbactor: MN LICENSE # Address: fJ Tel. :#. Attach to* this application,. a Certificate of. Survey of -the tot, . 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/Groundev?(j" Sq. Ft. OTHER: Comer. Lot [ ] Inside Lot[ , Ft. Yd Setback Side Yard Setbacks Type of Construction: ' 2 / 7�Estimated Cost: $ Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: S� APPLICANT: Tel. # CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ /'� .001 of Permit Valuation (1/10th%) State Surcharge $ , '�� $.50/$1,000 Valuation SAC Charge $ $850 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: SUBJECT G, City of Fridley 27444 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEI I � COMMUNITY DEVELOPMENT DIV. �y r � � PROTECTIVE INSPECTION SEC. 1 NUMBER REV DATE PAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 612-571-3450 910-F15 18128/98 JOB ADDRESS 4540 2nd Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5,N1/2 L.6 13 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Greg Miller 572-1708 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 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 16' x 26' addition to house 9 CHANGE OF USE FROM TO STIPULATIONS See notations on print. WANING Before digging call f6r all utility locations 454-0002 MPAMTE PERMITS REQUM foR REQUIRED BY LAiN VM3R'jNE, HEATINGs 'PLUMBIt{3 4ND Sid 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 BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 25185 $12.59 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. $358.75 Fire 25.18 PLAN CHECK F TOTAL 9 2 SIGNATURE OF CONTRACTOR AUTHORIZED IDATEI EN L ATE Is I$ R P YOOR�(AGENT x�, .� Y �'l ' ' /� �� 1 Q i _. BLD 11NSP MATE S4NAT E OF OWNER IIF OWNER BUILOE�i ID TEI NEW• • I ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: ��VO 2A _�4 , f E Legal Description: )®T 5- a -A , lV 5 e F � of 6 f' / oc. k % 3 Pl wky kU LIU- Owner Name & Address: c>�re.a t/sgo '24 St, �, Tel. # 572 Contractor: �_ MN LICENSE # Address: AJ st, Alr_ Tel. # S7,2 — 170 $ 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: L/ Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APP ICANT: Tel.- �C��,C� dam« l l CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge $, TOTt . L STIPULATIONS: 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 [ ] g .39G.Sy- • CITY OF FRIDLEY INSPECTION DIVISION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Effective On January 1, MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/1 -Ir *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HEATING COMPANY 1 Signed By r ; �� Tel No. 170 Approved By Rough—In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE JOB ADDRESS ys% S4, I VE, RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential (a� Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side Vent — Fill Out Back) A Z 21998 Gas Piping (Needed with new furnace) $10.00 DO P OWNER Com' 9 � •'e L t� Gas Range $10.00 $ BUILDING USED AS Gas Dryer $10.00 $ ESTIMATED COST ° �o PERMIT NO. *Air Conditioning — All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK 1 % of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercial/Industrial BTU HP EDR 1.25% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $ .50 Burner Trade Name �CQ1��- 610w Size No. TOTAL FEE$ o BTU HP EDR MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/1 -Ir *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HEATING COMPANY 1 Signed By r ; �� Tel No. 170 Approved By Rough—In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE COY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes ( ') No ( ) 2. 3. 4. 5. i Is free from rust or deterioration Has no foreign objects lodged within Is securely supported . Meets all current Code requirements for size and total BTU's connected Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: . List ALTERATIONS Beim Done: HEATING CO: Signed By: Date: Yes () No ( ) Yes () No ( ) Yes () No ( ) Yes ( ) No ( ) Yes ( ) No ( ) Yes( ) No " ( ) CIT.Y"OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Effective On May 10, 1999 Fridley, MN 55432 : '! APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES ,,1 JOB ADDRESS 4tM0 el ST N� �rvilty 55L12_1 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner . Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning.- All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work OWNERG� i�CY Rate TOTAL BUILDING USED AS $30.00 $ �� ESTIMATED COST PERMIT NO. $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10:00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ 10.00 $ Trade Name Size No. C BTU HP EDR $ 25.00 $"J + Fuel Total Connected Load_ State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr. ti *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Burner Trade Name Size No. $ BTU HP EDR 6 $ The undersigned hereby makes application for a permit for; the work herein specified agreeing to do all work in strict accordance with the City Codes an $ .50 rulings of the Building Division, and hereby declares that all the facts and �- representations stated in this application are'true and correct. $ gyMwj,DVEMUMPRO AIR CSCO. 410ViuEIRTWKESTW-7uo HEATING CO `'r��°Us MOD-2ma e Signed DATE Approved BRough-In Date Final Date FILL OUT BACK SIDE F R STACK VERIFICATION ON REPLACEMENT FURM Remarks: List ALTERATIONS Being Done: CBI%INEY AND STACK VERIFICATION The undersigned hereby verifies that --the =existmg-chimney or stack: 1. Has been carefully examined Yes O No O = 2. Is free from rust or deterioration a. :...._... Yes O No ( ) 3. Has no foreign objects lodged within Yes O No ( ) 4. 4 Is securely.: supported . Yes (..) No ( ) 5. Meets all -current.. Code requirements for size and total BTU's connected Yes O No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes(.) No ( ) Remarks: List ALTERATIONS Being Done: AW UlYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 January 18, 2001 Greg Miller 4540 2 St NE Fridley, MN 55421 Re: Final Inspection at 4540 2 Street NE Contractor: Standard Heating & Air Cond & Owner Dear Mr. Miller: Mechanical permits were issued on December 22, 1998 and July 26, 2000 for the installation of a gas fireplace and an air conditioner for your address. According to Section 305(a) of the 1991 Uniform Mechanical Code a final inspection shall be performed on the mechanical permit. As of this date no inspection has been called for. The permit fee that was paid covers the inspector's time to check to make sure the fireplace and air conditioner were installed correctly. We also need to check for caulking around the vent pipe through the wall. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, your permit will expire and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (763) 572-3603. Sincerely, DAVE/JFNSEN Buildftl Inspector DJ/mh suajEcr MIT NO. City of Fridley 29578 AT THE TOP OF THE TWINS BUILDING PERM O. `v -------COMMUNITY DEVELOPMENT DIV. SEC. r PROTECTIVE INSPECTION 1 � � E CITY HALL FRIDLEY 55432 "'' NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 II 5/28/99 JOB ADDRESS 4540 2nd Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. N 1/2 of 6 13 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Greg Miller 572-1708 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 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 12' x 16' Cedar Deck 9 CHANGE OF USE FROM TO STIPULATIONS See stipulations on plan. a Before digging Call for all utility locations 454.0002 REQUIRED BY LAW SEPARATE PERMITS ARE REOUIREO 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 BE COMPLIED $1800 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $.90 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 TOTA�ftli $6y.85 GN A TUREOOF CON TRACTOR OR AUTHORIZED AGENT IDATEI c HEN R P Y VALID AT is IS Y o SyGN0.X'1WE.1 OW NEA. IF OWNER BWL ERi IDA EI BLO INSF' MATE NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 454D c�PA St nG Legal Description: d PQ. Owner Name & Address: r-Tel. # 57a-1 fig' Contractor: —ff MN LICENSE # Address:I-b-1+16yd' Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF MPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground E/! Sq. Ft.� OTHER: Construction Type: /7 k 7 -�� Estimated Cost: $ ` l8e)� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: 5/Mjq 9 APPLICANT: �L�hL "'i (n Tel. # CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 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 $ C�9' STIPULATIONS: