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PRE 2010 DOCSIj BUILDING PERMIT N° 2326 Village of Fridley, M>Inn.I Date. .... ... ............ . Owner..,p� ......... Builder ....... i. .................... Address 0/ .. i� . *:i l�'' Address ............... { LOCATION OF BUILDING +� No. Street .... Part �of Lot Lot .. .. Block ..... Addition or Sub-Division ... ............... . Corner Lot ....... .... Inside Lot # ... .. ..... Setback :'� Sideyrd.........,...... DESCRIPTION OF BUILDING> To be Used as: s ' .... ..... Front JA A. Depthoth ... Height IS!.... Sq. i Ft......... Cu. Ft........ .................. Front ........ Depth ........ Height ......... Sq. ij CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL RATE TOTAL Furnace Shell and Duct Work, 20.OG $y� Burner $ e0 Gas Piping $ 10.00 $ (piping needed with new furnace) Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ Air Conditioning (all sizes) $ 10.00 $101 0 All Others/Repairs and Alterations 1% of Value of Appliance or Work $ COMMERCIAL/INDUSTRIAL 18 of Value of Appliance or Work $ State Surcharge $ .50 TOTAL FEE $ Reinspection Fee ($15.00) $� Rough Insp. Date Final Insp. J- 2 ft 'o Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS $.50 STATE SURCHARGE Attach stack verification form with. replacement furnace permits Effective Aug. 1, 1981 Job Address 6 0 �2_O 3 S,11- // E Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. /&A- . 19s;2-- OWNER KIND OF BUILDING s S USED AS 40s, e��'%�� // ��� ® /J/ r TO BE COMPLETED ABOUT ® ESTIMATED COST af ®ap -- OLD 'NEW BUILDING PERMIT NO. PERMIT NO. �02 SIO DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Bot Water, Warm Air- No. _A �04 gtoa Trade Name P�6 Size No. % ®O® O ®®® Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size Size No. Capacity le9O 0 Sq. Ft. EDR BTU! HP Company (/ Q��� Signed ByZ IL d Tel. No. 97/ SUBJECT PERM City of Fridley 18425 AT THE TOP OF THE TWINS BUILDING PERMIT _ r RE � COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 5/12/86 JOB ADDRESS 6020 - 3r d Street N. E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 11 6 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Harry Theroux 6020 3rd Street N.E. 571-1413 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Hoene Improvement 7401 Central Avenue N.E. 784-7543 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION X❑ ALTERATION ❑ REPAIR ,- ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS X»M$IM Roof can be the 2nd layer but not the 3rd. xK Install ridged galvanized valleys. 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 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 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 $1,270 $.63 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- STRU N OR THE PERFORMANCE OF CONSTRUCTION. $22.00 PLAN CHECK FEE TOTAL FEE AA - a��5 6 22.63 SIGNATURE OF CONTRA T R OR AUTHORIZED AGENT ID TEI I WHEN PROPERLYATED T IS IS YOUR PE MIT BLDG )NSP OATS SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW [ ] City of Fridley Effective 4/1/84 ADDh. [ ] �R-1 AND R-2 I ALTER. [ ] Building Permit Application Construction Address: ® Legal Description: Owner Name & Address: ��_/ ��`'/� �}- Tel . ! Contractor:C/ J i`7�/)'1� ��i�0�/�✓/ . Tel . # Address: / 7CJ� LC/�[•/�!�/t- l7'��, A/� . __ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT i 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. YYid. Setback Side Yard Setback /JT-/ /eDly- 4tS� ®/rdlu Estimated Cost: $ �27Q PV Type of Construction: dd J Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: _._ $ $ See Back Page for Explanation DATE: APPLICANT: Tel. # _ S CITY USE ONLY Permit Fee $ J.2- Q d Fee Schedule on Reverse Side Plan Check $ 25$ of Building Permit Fee State Surcharge $ (03 $.50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ DOTAL �� (c,3 Agreement Necessary [ ] Not Necessary $ STIPULATIONS: 1 SUBJECT NO. � City of Fridley (PERMIT 27 618 AT THE TOP OF THE TWINS BUILDING PERMIT r ` RECEIPT NO. ______ COMMUNITY DEVELOPMENT DIV. 1 ~ PROTECTIVE INSPECTION SEC. r 1 � 1 NUMBER REV DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 612-571-3450 910415 9/8/98 JOB ADDRESS 6020 Third St NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 11 6 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joyce M. Theroux 6020 Third St NE 55432 571-1413 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Owner 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 0 NEW 0 ADDITION O ALTERATION REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house (15 SQ) Tear -off 9 CHANGEOFUSEFROM 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 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 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 $1,285.00 $.64 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- $43.00 Fir SC $1.28 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTA EE $44.92 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI EN R VALIDAT IS IS P IT GNA E FOWNE' OF W ER BUILD I IDATEI BLIG INSP BATE 1 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2/ 6 BUILDING PERMIT APPLICATION ��P � 6% ConstructionAddress: ,,� ,� Legal Description: XOwner Name & Address:' z, Contractor: Address: Tel. # -5-ZZ-1-311-3 MN LICENSE # 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 GARAGE AREA: Length Width DECK AREA: Length _Width X OTHER: Construction Type: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Tel. # Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq., Ft. Estimated Cost: $ (Fee Schedule on Back) Ft x $ = $ x DATE: J' APPLICANT: Tel. # ,T- 7,1 —/l/ 3 . STIPULATIONS: CITY USE ONLY Permit Fee $ J 60 Fee Schedule on Reverse Side Fire Surcharge $ / .001 of Permit Valuation (1/10th%) State Surcharge / $ roil $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ r $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: Buildirfg BUILDING PermitNo.0100— ®(ASD Inspections RESIDENTIAL APPLICATION Received By�4-2007 763-572-3604 CITY OF FRIDLEY e�� DATE ' C'1 YOUR E-MAIL ADDRESS slTEADDRESS '`C. THIS APPLICANT IS: AOWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: (.OZ® re� 11. N C CITY STATIJ'I�LI IP S PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE 19 SINGLE FAMILY/NEW CONSTRUCTION SIZE F ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: WFEW ❑ ADDITION ❑ MAINTENANCE/REPAM ❑ REMODELING DESCRIBE WORK BEING DONE: Gs 1 a X SIZE OF IMPROVEMENT � �H LENGTH WIDTH ci,a HEIGHT Sq. Ft. 2 ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES PROPOSED SIZE: ❑ ATTACHED GARAGE ❑ DETACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED HEIGHT: '�6- 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other . ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OFWINDOWS ALL FFES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: 1-1`7,93.0,4 (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ S ew OCCUPANCY TYPE Permit Fee $ ' y of See Back Page for Fee Schedule Plan Review $ 90 65% of Building Permit Fee Fire Surcharge $ '7 .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary( ) Non Necessary ( ) Total Due $ Make checks payable to: City of Fridley Attach Stipulations _ THIS IS AN APPLICATION FOR A PERMITNOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and wor not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requy¢es'PProval of plans. SIGNATURE OF APPLICANT PRINT NAME e /r) it /d,%A DATE /' 6 4z $ THIS JOB COPY SHALL Fj AVAILABLE ON THL J - SITE FOR THE FRAMi AND FINAL INSPECTT 10"'ll S ENGINEERED TRUSS DESIGNS AND LAYOUTS SHALL BE MADE AVAILABLE ON THE M SITE FOR THE FRAMING INSPECTION ald qV-- I � t_4 v .4. YO J 2 }r/ Ii Av-- ^'. list ij( • � ,J1 II1 f 1p��l Menards.com - Featured Garage Featured Projects - 2 Car - X Sable Entry This can be your new garage for $3,190.00 (approx. price per material lists) Featured Garages o,This building features construction lumber, pre - 1 Car assembled trusses set at 24" on center, 2x4 walls 16" on center, one 16'x7' insulated garage door, one entry 2 Car Y Y x t ` door, nails & fasteners. 3 or More Cars Specialty SPECIFICATIONS Total Area: 528 sq.ft Plan: 1950979 Package includes: ■ Treated sill plate ■ Siding ■ Roof Sheathing ■ Garage Door(s) ■ Service Door(s) ■ Shingles ■ Nails & Fasteners ■ Plan Different siding options and sizes are available. For more information or to design your own building on our Design -it Center®, visit a Menards' building material department nearest you. Store Locator 'You may buy all the materials or any part at low cash and carry prices. Because of the wide variables in codes, Menards cannot guarantee the material list will meet your code requirements. These are suggested designs and material lists only. Some items may vary from those pictured. We do not guarantee the completeness or prices of these garages. Labor, concrete floor/foundation, steel beams, paint, electrical, heating, plumbing and delivery not included. Please inquire at the building materials desk. Some special order truss sizes must be jobsite delivered. Delivery is extra. ,r httn://www.menards.com/featuredProiects.do?sortBv=title&t)aRe=1&tune=2 Car&totalPages=3&dispatch=show0neGarage&co Page 1 of 1 - 4/19/2007 C4L e� (e -*-*)l I� Com. �`� nr, �,1�-�-� n�P ..... WIR13� ? Z if16h� I US ef� V% 1i1. J REVIEWED � j FOR CODE �4 , 7LIANCE �4C4� t adv 17 F+ e , k7t— .. `°' :.} u SEPARATE PERMITS HMIlIRW FOR: PL M6� ANDS 7- a, a �+ ��� I` F M� 5��3? ._.,�•. ,_:, ary a,..�.wkt,�,.T. . _ t!ii AVAILABLE J08 COPY SHALL BE ON TRIG JO SITE FOR THE FRAMING "l�z TE F�i� <<;��G it4'.S►�ECTCO�k AND FINAL INSPECTIONS C4L e� (e -*-*)l I� Com. �`� nr, �,1�-�-� n�P ..... WIR13� ? Z if16h� I US ef� V% 1i1. J REVIEWED � j FOR CODE �4 , 7LIANCE �4C4� t adv 17 F+ e , k7t— .. `°' :.} u SEPARATE PERMITS HMIlIRW FOR: PL M6� ANDS 7- a, a I` F C Alj�,AGe 5i -DIE QFI cQ�tC- WTI4j COPY SHALL BE it" C1vckl419KGsS $9 T-SSSS'S AVAILABLE ON THE JOB F: g.A, °'�a�= �';;�'_L By ����E SITE FOR THE FRAMING 4 °► I . BI E O6': $HF 109 S1'E AND FINAL INSPECTIONS p OR THE FRAMING INSPECTION Ale SAwcor. N Ai 4d ni,4 Jr -a *- C.ec,,Q, 3 mz tin" CCo W•�� ? z 3/ zy, 7 ' REVIEWED FOR CODE WRLIANCE 13L1)Gynsspc PEWS , y jkj� A -I. R�QUtR�D FOR: WRING HEA pLUMBINO AND (if I(1/\kN CC)Q mel o- loC. F-vyOtE CI F -Q f N r', C.Q Design # 11659 Vrage I of I M�� Take this sheet to thBuilding Materials counter to purchase your materials. 711012007 e You have selected 9,,Q,arage with: 22' Wide X 24' Deep X F High No additional options were selected Gable roof wl 4112 pitch trusses 2' O.C. 2x4 Wall Framing Materi6I 12" gable/1 2" leave overhangs 7116" OSB Wall Sheathing 7116" OSB Roof Sheathing P. Wheat Vinyl 4" Dutch Lap, Siding 35 yr. Biltmore, Slate Shinges Plastic Roof Vent, Black Almond Aluminum Sotit & Fascia''' Almond Premium Roof Edge Pine Overhead Door Jamb f; Today's cost for materials estimated in this design: $ 3366.57 'The base price includes: 0° Eave10° Gable Overhangs, Framing Materials, *(BASE price): $ 1765.98 7116 OSB Roof Sheathing, 20 yr. Fiberglass Classic - Onyx Black Shingles, Pine Fascia, Galvanized Regular Roof Edge, 8"Iixtur� Vertical Hardboard Siding, No Service Doors, No Overhead Doors, No 1NindM, or Any Other options. You may buy all the materials or any part at low cash and carry prices. Because of the vide variable in codes, Menards cannot guarantee that materials listed will meet your building code requirements. These plans are suggested designs and material lists only. We do not guarantee the completeness or prices of these structures. Tax, labor and delivery not included. Building AND MATERIALS: BUILDING ��(USING Permit No.: Inspections � RESIDENTIAL APPLICATION Received By: 763-572-3604 1-' See Back Page for Fee Schedule Plan Review $ �•, Fire Surcharge $ CITY OF FRIDLEY Surcharge Date l 763-502-3604 FAX License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ EFFECTIVE 1-1-09 Curb Cut Escrow $ DATE 1 E-MAIL ADDRESS p 1� 11 t� "�o��� (L. SITE ADDRESS t�U a. C) aYOUR c tx 'SA. QC- CTHIS $ THIS APPLICANT IS: f 29;QWNER ❑CONTRACTOR $ PROPERTY OWNER/ NAME: �r a $ TENANT ADDRESS: Lv ad 3 �+ S� . �=ZIP CITY STATE S PHONE: CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION MAINTE``NANCE/REPAIR ❑ REMODELING / DESCRIBE WORK BEING DONE: C G &. SIZE OF IMPROVEMENT LENGTH 3 WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, Iff Vinyl gsoffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other Q Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE ORWINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: ��(USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ � OCCUPANCY TYPE Permit Fee $ 1-' See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 0 .001 times the total job valuation Surcharge $ S .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks Davable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work whic re review and approval of plans. SIGNATURE OF APPLICANT. P-/7-0 � PRINT NAME JdN Lt /� DATE d' - l 7- 0 9