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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT (=4746J Date: Owner: Builder Address ...__'_ .` Address ........ .._..._______._.._.._..___.._.. CA N OF BUILDING .. street _ _..,°ALO. ...' ......._. No. _ _Part Lot_ ..:' ......, Block .....__....... _ ........ Addition or Sub -Division ... Corner Lot ....._ ............._...._........ Inside Lot .................._.......... r „ ...... Setback ._:..:�:.................... 5ideyard-•----1E!'.•-----....... ... -........... Sewer Elevation . ........... ......................................... ...._......._..._._..._...._........ Foundation Elevation _ ..................... .... ___..___.._ _._......__. _. _. _. DESCRIPTION OF BUILDING To be Uas::�s __...._ =,.-------•--- _�Cnt .---..De Depth ht Sq. Ft-/ Cu. Ft����4,.�•**� ........- ........._...:..._..:._._..... nt .....- ..:......_.. Depth ....._... Height .................. Sq. Ft. .............. ... _.. Cu. Ft. ........ .......... .. Type of Construction ...._ ,: _; Est. Co...... ...� J�C��-....._........ To be Completed ........... . ............ THIS PER17f F L)—"ENOT AUTHORIZE VIOLAT- ION OF ANY F'RivJE LAND COVENANTS AND BUILDING RESTRICTIONS. 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. e�? +''/,............... ------- "'.^'------ .._.._....... ._.......�_..._._ A .r.. ........y permit is hereby granted to..._.......__-- ............._...._.......---•--•---- In consideration consideration of the payment of a fee of $.Cv 4 ..... . 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 time upon violation of any of the provisions of said ordinances. Inspector NOTICE: This permit does not cover the con"clion, Installation for, wiring, plumbing, gas heating, sower or water. Be sure to we the Building Inspector for separate pormiti for these items. 41W4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners N6me�./ dL� Builder R Address .,-,, 2. V_a v ems, Address LOCATION OF BUILDING No"treet ' < 4,44fT _ Part of Lot -3 Loth Block • 'Addition or Sub. Div, Corner Lot Inside Lot Set Back Applicant -attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as Front. Depth D Height. Sq. Ft: 1�.oa Cu. Ft. 3 Front _________ Depth Height Sq. Ft. Cu. Fta ...�..� To be completed "be undersigned hereby makes application.for a permit for the work herein specified,•agreeing to do all.work in strict accordance with the City Ordinances and ruling, of the Department of. Buildings, and hereby' declares that all the facts and representations stated in this application /:3.1<5`m /AIS are true and correct, Date ���3— Signature (L.Schedule of Fee Costs can be found on the Reverse • y /y City of Fridley Application for Plumbing and Gas Fitting Permit T% --f . f Bld Pho 30 4 7470 DESCRIPTION OF WORK Number. Kind and Location of Fixtures O6��p Q RATE TOTAL Number Fixtures .................. = $1.50 $ - � � �4n O 2 1.20 W Z x WATER H11L $ Catch Basin ............................ Water Heater 4.3fi x ®'F m w 3i- ou x �o $m a3 Oa Ufa t�0 F N GAS ELEG NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 s Additional Fixtures .................... 1 _ x .50 Gas Range to 200,000 BTU .............. x 2.00 $ Base / 1st 2nd 3rd 4th • Future Connection Openings Connected With New Fixture, Old Openings Sealer � Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Q RATE TOTAL Number Fixtures .................. x $1.50 $ - � � Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ Water Heater x 3.25 3 (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 s Additional Fixtures .................... 1 _ x .50 Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEB g� Location � �z® =6tea , -, . City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings/hnd Buildings/hereby declares that all the facts and representations stated in this app lic on true and correct. Fridley, Wnn,- 19—C3 e Owner y 19 Kind of Building , 19 Usedas To be completed about Estimated Cost, $�� P Oldew. uilding Permit No 9=a Z7 /-Y e r Connection Permit No . ....................................................... Water 11-0 ® �'°`�% Sewer ' Meter Deposit 11 IM -8-58 '�/ I 01/-' City of Fridley Application fow Numbing and Gas Fitting Permit DESCRIPTION OF WORE Dept of Bldgs, Phone SU 4-7470 Number. Kind and Location of Fixtures Locaiioa 61z RATE TOTAL Number Fixtures ...................... x Y '� �pp z= z W New Fixture Old Opening .............. w z q, F N WATER HTR. x 3.25 $ 4. x 2.00 $ New Ground Run Old Bldg . ............ ? x 3.25 $ O� NO. a3 �Q �a4 �p x $1.50 $ GAS ELEG 02 .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ Base 1st 2nd 3rd 4th • Future Connection Openings Connected with New Fixture, Old O Openings ❑❑ Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: RATE TOTAL Number Fixtures ...................... x $1.50 $ 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 TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE It � O v r City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application 'true and correct. Fridley, Owner og ` ,. 19 Kind of Building 1/1-7111 Used as - / To be completed about Estimated Cost, Old ew Building Permit Connection Permit No . ....................................................... r ' Water Sewer Meter Depot 11 IM -8-58 W, t Appfication for Power Plants and Heating, Cooling. Ventilation..Reh Nei anon and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace S1.hell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ........................ 2.00 $ Replacement of Furnace §.00 $ Repairs & Alterations—up to $500.00 ....e ............ 5.00 $ Repairs & Alterations each add. $500.00 ....... :...... 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam....... 8.00 $ DD Li Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $-a 7th Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL F$E ROUGH FINAL Dept. of Bldgs. Phone SU, 4-7470 Locatfon,��r!L"--o �, — City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Owner Kind o] �nn _ Used as AW14Z To be completed about, 3® 11q'6 d Fridley, Minn- ?,e 19� Estimated Cost, $ Old ew uilding Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam 'ot W' at�er� Warm Air—No+-.-Y Trade Names Size No -3 Capacciity Sq. Ft. E.D.R BTU H.P. Total Connected LoadU, A VS O WWd-ZX &Z'Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. 2 a z 2M 7-59 (REMARKS—OVER) • � - L �' ���__ /rte G L r j Application for Pourer Plants and.. Heating, Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... .................. 2.00 $ Replacement of Furnace ............................. .§.00 $ Repairs & Alterations—up to $500.00 .... ............ 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam....... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal, per hour—See Fee Schedule / �— GAS BURNER (up to 400,000 BTU) ................5.00 $ GAS FITTING FEES: ((( NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. ✓x .50 $ Z, Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL $ See Fee Schedule TOTAL FEE Dept. of Bldgs. Phone SU, 4-7470 Location— City ocation City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application true and correct. Fridley, lg Lo Owner % Kind of Building Used as To be completed about ! ✓�'Y%� Estimated Cost, Old—New. Building Permit No. Permit No.,// DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuer BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Si Ptl 14 a - I By la _ a. .J 42 2M 7.59 Business Phone No- 'G 6 iL City of Fridley, Minn.. BUILDING (PERMIT N° 2 3 2 Date: "" eel — r� , �- Owner: Builder _J _-- 4 Address Address LO N'IBUILDING No. sr Street – !- Part of Lot Lot — _ Block Addition or Sub- oh Corner Lot _ Inside Lot000�-iEback Sideyard— Sewer Elevation _ F dation Elevation DESCRIPTION OF BUILDING To U Front Depth _-O� Height Sq. Ft. Cu. Ft. ort Depth ----,He]t ,_ Sq. Ft. Cu. Ft. Type of Construction 410- ==40 0 Est. 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 m compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ Q – , 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 time upon olatio� y of the provisions of said ordinances. �,r� , , Inspector NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas hosting, sewer or water. Be sure to see the Building Inspector for separate permits for (hese'Items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name Anv�� Builder ��y Address J 70 E Address `n LOCATION OF BUILDING No. Street Part of Lot Lot Block Addition or Subdivision Corner Lot _____Inside Lot Setback Side -Yard SIM ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used DESCRIPTION OF BUILDING Sq. Ft. Cu. Ft. FrontDepth Height Sq. Ft. Cu. Ft. Type of Construction :�� Estimated Cost � e ® 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 Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. ,12 DATE s� 'Ab Q_ (A Schedule of Fee Costs can be found on the Reverse Side.) 0 0 SUBJECT NO. City of Fridley 2735 Z5iiF?I-PT AT THE TOP OF THE TWINS BUILDING P E R M I r NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY "1 CITY HALL FRIDLEY 55432 612-571-3450 910415 18/21/ 98 JOB ADDRESS 5370 5th Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13,4,5 14 Hamilton's Addition e SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Daryl Bergstrom 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Viking Home Im rove e57?-189r) 4772 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 Reroof house and garage 24 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 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 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 2001 $1.00 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- ON OR THE PERFO MANCE OF CONSTRUCTION. 7 75 Fire SC 2.00 -��y XS AN CHECK FEE TOTA EE Lice 5 0 8 NATURE PF CONTRACTOR O UTHORIZEDAGEN IDATEI EN ROP VALIDA D IS UR PERMjT BL G INSP 0 U r ��°TE _ SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW. ADDN [ ] ALTER [ ] ConstructionAddress : CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 70 Legal Description: Owner Name & Address: Contractor: ( i o�/ Av� lkldp Address: ��,� v /t%� Effective 1/1/98 I Tel. # MN LICENSE# `7`' 77'L L_Tel. # -57Z—` u Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%IPROVEMENT 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: �� Pe �v Estimated Cost: $ 41V V (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 4(- 2V APPLICANT: Tel. # �l CITY USE ONLY . STIPULATIONS: Permit Fee $ /"OS Fee Schedule on Reverse Side Fire Surcharge $ OCA .001 of Permit Valuation (1/10th%) State Surcharge $ /,00 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ 'GC) $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 PERMIT N City of Fridley 33476 AT THE TOP OF THE TWINS BUILDING PERMIT r � RECEIPT NO. � COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. NUMBER REV1 DATE PAGE Oi El GITY MALL FRIOLEY 55432 %j 763-571-3450 910415 ] 4 / 2 8 / 03 / / JOB ADDRESS 5370 5 Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3,4,5 14 1 Hamilton's Addition to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lee Swanson 5370 5 Street NE 763-424-2927 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Custom Home Remodeling 4517 5 St NE, Columbia Heights, MN 55421 763-574-9769 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20317269 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Convert existing window to egress window (32" x 18" to 32" x 48") 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. 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 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 1 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 @ $1.15 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,300 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. STRUC $83.25 Fire SC $2.30 ON OR TM RFO NCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE ��Sd 3I±uen#e SC $5.00 $91.70 SIGNATURE OF CONTRACTOR OR AUTHORi2 (DATE, 9 NEN PROPERLY VALIDATED THIS IS YOUR PERMIT A Ina JG g i r)& F1 S-GNATURE Of OWNER„f OWNER BUILDER, iDATE, NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: -i-3-7v 5S St ^f -f- Legal. Description: Owner Name & Address: Le—p— SW a n s ©� Tel. # "7 �3 - S� �IZ��' 2827 Contractor: C.usiom OoAke 6'LP�®��� �� MN LICENSE # 8C- Zo3 i 21Qat Address: `iS k-1 5V- 9t. NE- eoloMbEz 42.GIL fs Tel. #fib - Sl�l��7 bq 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: Lend Width Hgt/Gro nd Sq. Ft. OTHER: �� 73 Construction Type: Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: ! Z$ v APPLICANT: `�� �� Tel. 0-1b3 574- 00 6°I Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ 9/,70 CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 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 [ ]