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* City of Fridley, Minn.. BUILDING PERMIT N® 4375 Date: .........._...`._................_.............---------..----- e Owner: ..... ........................................................... ................................... -.................... Builder ...... ..... -. _........... . .......... /.0 i�� �i Address /CATI NOF BUILDING No........,1 Street....._.......-,.��:................. ........ ..r ..................... Part of Lot ............................ ......... ----------.........._. ._... _.. Lot �...�� .................. Block .--- ........1 ....... - ............. Addition or Sub -Division .4( xr ....._.----._.. . CornerLot ............ _ ................... Inside Lot...X....... ....... .............. Setback ................ ............. _.._® Sideyard ................ _............... ............. ............. .... _...... Sewer Elevation To be Used as: sl............. ..._..... _ .............. Type of Construction Foundation Elevation DESCRIPTION OF BUILDING Front .. _� Depth 1V.� Height .. .... Sq. Ft... .(0...® Cu. Ft. 1...._u.��� Front .................... _.. Depth .......... ...... Height ................. Sq. Ft. ........................ Cu. Ft. ......... Est.st...// F.....®.FOR-...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. r Celle? .. - a In consideration of the payment of a fee of $ AAF 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 violation of any of the provisions of said ordinances. Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. .411J0.4 1 r APPLICATION FOR BUILDING PERMIT -' CITY OF FRIDLEY, MINNESOTA Owners. e. .' L ----o Builders - Address.' Address LOCATION OF BUILDING ? No._�-e^Street Part of Lot Lot 'Block / Addition or Sub -Div. Corner Lot Inside LotSet Back Sid -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicantattach to this form.Certifica.te of Survey of Lot and proposed. building location. DESCRIPTION OF BUILDING To beu as: � - G FrontC `� Depth Height Sq. Ft. C Cu. Ft: . Front Depth Height Sq. Ft. Cu. Ft. Type of Coxistruction 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 Ordinances and ruling of the Department of Buildings, and hereby declares thaZ,all W facts and representa- tions stated his pplication are true and correct DATE /, `T ----SIGNATURE__-_� (A 6chedule of Fee costs can be found on the Reverse Side.) • 0 W '11* City of Fridley Application for Plumbing and Gas Fitting Permit Dept of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location � 4t" — � ` 0 NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ vi 3 o New Fixture Old Opening .............. K Z 8 i� o n v < 3 , t`9 'd w (�9 Z �U' O • F h N WATER HTR. GAS ELEC. Base GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... Z x $1.50 f Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ 1st 2nd 3rd TEE 4th I I I • Future Connection Openings I New Fixture, Old Openings Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. 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 $-2g New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... Z x $1.50 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description................................................$ TOTAL FEE $ �® 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. Fridley, Minn %, 19� 99 Owner-11;;71/ wner✓/ �n� I 19— Kind of Building � -/t���� 19— Used as To be completed about Estimated Cost, $ Old—New. Building Permit No / Sign DEC 2 9 1960®Ugh ,413�0,11 POST IM -12-58 Business Phone No 6%�(- l Application for Power Ptants and Heating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7470 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 ............ each add. 60,000 BTU ....................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 .............. STEAM or HOT WATER SYSTEM 8.00 $ o 4) 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. 2.00 $ Owner 5.00 $ Kind of 5.00 $ 2.50 $ Used w I Furnace Shell & Lines—to 400 sq. ft. IDR 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 1st 3 Fixtures ...................... x $1.50 �+TOTAL $— 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 FEES REMARKS: To be completed about Estimated Cost, $ Old—New. Building Permit No. DESCRIPTION OF WORK HEATING or PO - R IT ANTS—Stun, Hot Water, Warm Air—No Trade Nam `` Size No S Capacity �q. Ft. E.D.R. BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. ®110 Sign - 11 POST IM -12-58 Business Phone No NUT LOU CALCULATIONS DIPARTM BUILDINGS MDL1Y. MINK WeathenWp _ Condruction No.Guide I s Reference Out. Wail Int. Wd Ceding Roof Floor HeMr 19 Fl Room Length 14 s Width Height 81 II Fl. Room Width 11 Windom and Doors--Crackase and Area �Au of e.ao4 � K. 3� t � i '9 aWHO a.cea� Z Z O Mor ZZ$ (o TOW Bat. g Required sq. It. E.D.R. or sq. ics. W.A. Leader area Fl•I . T• li t J Room L.enotL 1-7.1t Width I 1 I Haism R Wamdom and Doom—Craekage and Area t 3 tfa of of Deme Hebte of - ok 24.mArea v 4- 4 I. �! ( Q 19 Coef. Bat �a� 5,0 Met ow. waN Ciao Int. wall 0 0 WAR . 0 5 Not esp. wall ��aas� • het. wall m .. . ceding 3 0 36 Flow 4 1001 tent 9W --Required $q. ft. E.D.F. or sq. ices. VA Leader area RUssl'�71� zL��lM: "`T:. wld& els\t e. No. of Paso otp-smo-j ltatYte of enwk n. 2 3z. 1t` 4EI4 lniitration 7. 12-9 Glass 11L 110 EMEnur-T1m. Met ow. waN Ear, wall Int. wall Net ev. wad let. wall WAR . Floor I 21 Floor ��aas� • _ m .. . low Opt. aq. ft. E.D.R. a sq. iris. W.A. Leader area Windows and Doot�—�Cr and Ara tt wld& els\t e. No. of Paso otp-smo-j ltatYte of enwk n. 2 3z. 1t` 4EI4 lniitration 7. 12-9 Glass 11L 110 Eap. wall Met ow. waN Ear, wall Int. wall Net ev. wad let. wall Ceding 21 1C l 12:10 Floor I 21 Floor Total Btu. Required sq. ft. ED.R or sq. ins. W.A. Leader ane F1.1 WeN R000t I Lemlth I t 1- V Al 'WIL Heinle !t t Windows and Doors--Crachw and Ates —width 1141cht aat sea na Nee of of !tear of crack ft. 24 r& Infiltration TZ R Glace 2. E400 Ear, wall Net ev. wad let. wall Ceiling Floor low tt:tf. Rued iq. a E DJL or sq. iia. W.A. Larder am dr -.1.1 Room I Lenelel W VxM Hairlt PR t F r� m ao. ft. M& ice. art_ iaa. X111 Asda..... City of Fridley, Minn. BUILDING PERMIT N°fto 0 4 2 Date:, Owner:�� _ r,r_;'�it_ "of Builder Address Address LO ON OF BUILDING, Street _ t-: Part o! Lot Lot _ _ __ Block Addition or Sub- vision Corner Lot Inside Lot—� Aback " _ Si yard _ Sewer Elevation Fo dation Elevation DESCRIPTION OF BUILDING To ,r Front Depth Height.'/_e f _.: +�-� Sq. Ft.. r , Cu. Ft. Front Depth Heigh Sq. Ft. Cu. Ft.Type of Construction - Est. Cost :f 9??:_ 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 ail provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of permit is hereby granted to to construct the building or addition as described above. This permit Is granted upon the express condition that the person to whom It is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. �. AA --i Building Inspector NOTICE M permit does not cover the condruedee, laemMon for whiny, pitn"B, on hrattna, sewer or water. Be an to as the Budding Inspeder for separate permBs for thea flan. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name ifph��r� �� �Builder Ao _ o ewid e p' Address to oilo S f� d LOCATION OF BUILDING No. Street part of Lot Lot_ Block_Addition or Subdivision s Corner Lot Inside Lot A-"*' 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 be used as: P ' Front o2 % Depth ;?;2- Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction -f-��.,, Q Estimated Cost is®O 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 rare true and correct. SIGNATURE /�dz�� (Schedule of Fee Costs can be found on the Reverse Side). p1/s ■. • J r City of Fridley, Minn. N° 7794 BUILDING PERMT-8/-8/ • Date: June 9, 1965 C • Owner: Herbert Evans Builder McCall and Com. @= Address 6261 6th Street K. E. Address 1618 W. Iake Street LOCATION OF BUILDING No. 6261 street 6th Street N, E, Part of Lot Lot 3 _ Block l Addition or Sub -Division _ Uplands., 2nd Add. Corner Lot _ Inside Lot Sewer Elevation To be Used as: Setback —_ Sideyard Foundation Elevation DESCRIPTION OF BUILDING Front — Depth Height Sq. Ft. Cu. Ft Front Depth Height Sq. Ft. Cu. Ft Type of Construction Est Cost p900,00 To be Completed Storm damage repair 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 21 provisions of ordinances of the city of Fridley. � r In consideration of the payment of a fee of $10.00 permit is hereby granted to McCall & Co. Don Donahue 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, small conform is all respects to the ordinances of Fridley, BSinnesota gg location, construction, alteration, maintenance, repair and moving of buildings within the dty limitstbis permit may be revoked at any time upas violation of any of the provi®tons of said ordinances. Allen Jensen Building Inspector NOTICE: Ible pwu* don not emm tho donMuddon, huhlla an for whfn , plumbing, gas hatho deww or wdw. Be dOra to da iia Building ingmftr for npardto pwmhd for than Mona. a APPLICATION FOR ING PERMIT CITY OF FRIDLEYt LMSOTA OWNER'S NAME HERBERT EVAIJS k r ADDRESS-- 6261 - 6th St. kE ADDRESS_ LOCATION OF BiIN(; No.. Stteet Part of Lot . , Lot Block Addit.iow or SubdIvisien Corner Lot Inside Lot"_.__..,..Set.b4ck Side -Yarn SEWER `F�LEVATIQN FOUNDATION ELkVA17O1L_. . , Applicant attach to this form, Two Certificates of. Survey of Lot and proposed'bwildw- ins location drawn ori these Mrtificates . To be used as: DESCRIPTION OF BUILDING ronC Depth Height � �. ... If - CU. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost $ l 000x0 The undersigned hereby makes application for a permit for the work -herein specified; agreeing'to do all work Ift strict accordance with the City of Fridley Ordinances and rulings if the Departw�;n 'of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. chedW _of Fee Costs can be found on the Reverse Side). CoVlete roof house and garage. New siding. Painting. General repair. Application for Power Plants and Healing. Cooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... $10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............$10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ..................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ .®O over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 200 $ ®� Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING vim® FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE �® ROUGH FINAL Dept. of Bldge. Phone 560-3450 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. 00 Fridley. Minn- Owner �//� if &; Kind of Building Used as To be completed about Estimated Cost, $ �®Ca (9—New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --,Steam, Hot Water, Warm Air—No Trade N�'i 97/ei Size No- ,� 1601Z Capacity Sq. Ft. E.D.R J�p®L'�!%1 BTU_�� Total Connected Load ! E �I'Z �. �� Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Business _ 5 12 City of Fridley Application for Plumbing and Gas fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK 6261 NE 6 St• Number, Kind and Location of Fixtures Location ppI Gl 3 7 € x $1.50 12• a �n ;I- ZFi OLL ujc p Z iTj 2 p WU' 5 �n -i7� LLD U GS Cid i <� 7n P • N WATER HTR. GAS ELEG Base $ Electric Water Heater a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL lot i -,om i yd g 1 2nd 3rd 4th • Future Connection Openings * New Fixture, Old Openings Conn®cted with I Sewer � Cesspool El 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 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... 1 x $ .75 $� Gas Range to 199,000 BTU .............. x $5.00 $ j OO REPAIRS & ALTERATIONS—Refer to Code City of Fridley: 912,02 The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn- 23 ADr 68 , 19— Owner H E ''ma Kind of Building t r Used as res To be completed about Estimated Cost, $ 5.00 - Oldv. Building Permit No Permit By iaWO&LIS GAS Co. Business Phone No ROUGH FINAL / Z Description ................................................$ TOTAL FEE $ 5 • 00 e0630.42 I� SUBJECT .City of Fridley 13862 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT N • COMMUNITY DEVELOPMENT DIV. �----y- --� PROTECTIVE INSPECTION 'OO. ,�-V r � � SEC. Oy_ /" � J CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �•--• %.J 612-560-3450 910-F15 11,15176 JOB ADDRESS 6261 .6th Street N.E. 1 LEGAL LOT NO. BLOCK TR ACTOR ADDITION SEE ATTACHED DESCR. 3 1 Upland 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Herbert Evans 6261 6th Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Blaine Construction, Inc. 10152 Butternut St. —T -ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. SAME 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING residential 7 CLASS OF WORK ❑ NEW OX ADDITION I] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Family room 25' x 14'8" and storage shed 14 x 20 9 CHANGE OF USE FROM TO STIPULATIONS 1. Provide 5/8" type X sheet rock in Northeast corner of garage 2. Provide approved fire door with closer in N.E. corner of garage. SEPERATE PERMITS REQUIRED ''FOR WIRAN, HEATING, PLUMBING AND SIGN& SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. frame OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT.366& 280 CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION p X3219 7320 & 2800 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. $15,500 7.75 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- 65.50 STRUCTIO OR THE PERFORMANCE OF CONST CTION. f PLAN CHECK FEE TOTALFEE ` 73.25 SIGNATURE OF CONT ACTOR OR AUTHORIZED AGENT (DATE) EN PROPS IS IS YOUR PERT/ YAL;1D;TE2DT 11 BLDd INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) I� CITY OF FRIDLEY APPLICATION FOR. RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER'S NAME: BU ILDER: ��� ADDRESS: ADDRESS: TEL. NO.: 25 /?1 72 0 91 WO:. L / STREET : LOT: BLOCK: ADDITION: CORNER LOT: INSIDE LOT: _SETBACK:_ e'S SIDEYARD: /0 ls.t - e � r -w f•� Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: 4414 4;.< Front: Depth. /y' d `' Height: / °j f /y 14 ::1p Square Feet: ��'l 4 Cubic Feet: 7310 Front: Depth: .2 a Height: Y -/2' Square Feet; d,* e) Cubic Feet: ;Z 60® Type of Construction: ��,,,,. Estimated Cost: $ /S -Sao .'To Be Completed:�" 0 )9) The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stxict 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: 111-91-24 SIGNATURE: (See Reverse Side For Additional Information.) ,S7•lP �►�I 4r 6z. 93 93 .2-t> p'ej (Jt or— &*E T Po oe o v A**001 C+¢"4e ox goo" e �� ,Pe6 (/10L 400 &/ e D *t A9 n LU Z tW r-' Main Office 7846066 IYREAN 6875 Highway No. 65 N. E Na1NBeRINO Minnwpolis, MlnneaoL 5%32 t South office 8906410 Cwd & Mururipal Engineering • Soil Testing • Land Surwy,ng • Land P4uuung 1101 Cliff Road 11 Burnsville, Minnewft 863197 Certificate of Survey for BLAINE CONMUCTION . L�Co A/orih line or 1, Rloel< 1, Up/and 20 gddi tion moi- to CHORD N p — 110.31— c` FRAME GARAGE 22.25 N � ZdV N22.25N� 2ti}/ -3 ' 14 South line q, Lot 1, Block 1, upland 2NU addition o Denotes iron mon umenf OCTOBERS 1970 LOT 3 , BLOCK 1 UPLAND 2ND ADDITION 5c0/e : 1 inch goikl ANOVA COUNTY J hereby certify that this is a true and correct representation of a survey of the boundaries of the above described land, and of the location of all buildin r, th reon, and all visible encroachments, if any, from or on ' said land. As surveyed by me this.may,9 day of A.D. 19 ? SUBURBAN ENGINEERING, INC. t L 3CS Engings, 'ury sby 150A Page 1 of 4 EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER: He i , f 2r,, di s DATE SITE ADDRESS: aL �- S*. ,V _ PHONE: 7gy-71 no CONTRACTOR: 1,541"Xca �r r Tri idH �h e Determine working square footage of each 1. Total exposed wall area...... 37S -o sq. ft. x .17 2. Toal roof/ceiling area ...... 3G 7 sq. ft. x .05 = Total exposed wall area above floor y ,B a. Total wall window area ................................. 91? b. Total door area ....................................... c. Total sliding glass door area ......................... y o d. Total fireplace wall area ............................. 4q - e. Total wall framing area (average 10%) .................. 3J f. Total rim joist area .................................. 57s - g. wall area above floor .......................... a7u h. wall area above floor .......................... i. wall area above floor ........................ j. wall area above floor .......................... Total exposed foundation area = SJ - k. k. Total foundation window area ........................... P 1. Total net foundation area above grade ................. yr Determine "U" value of each wall segment (e.g. window, door, each separate wall section) a. 3 X $lulu b. X "U" _ C. 0 X fluff d. X "U" e. 3I X "U"( f. ,sr X bull , 03 g• aS, � X fluff ; as% h. X '1.U1l= j• X "Ul' _ k. 7 x "U" , ,-N = 3, 7,f X tom' X07 = 3.36 000 3 . ............................. Total - U I If item #3 is the same as, or less than item #1, you have met the intent of SBC 6006 (c) 2. V Exterior Envelope Average "U" Computation Total exposed roof/ceiling area = 34 7 m. Total skylight area ............................ n. Total roof/ceiling framing area (average 10%)... .36 o. .Total net -insulated roof/ceiling area........... 4 31 Determine "U" value for each roof/ceiling segment Page 2 of 4 M. 3 X "U" '65-2 n. 3 3 X flull bzx o. X "U" _ 4 ........:.................. Total = 'r, 7'? If total of #4 is the same as, or less than 42, you have met the intent of SBC 6006 (c) 1. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than the sum of items #1 and #2. 1. s -v + 2. J7, 3 S --s- 3.-, ga + 4. ./s 7i = //a, r.7 WALL SECTIONS NOTE: Use 10% of opaque wall area for frame construction 'Zia. ��1SCAL. --�L�1lCl SS F1G. #3 FRAME SCALL p 16 Page 3 of 4 Construction R -Value 1. 2. 3•• 5. Interior air a arro�c/ S film fwd 0.68 N, 35• 6. Exterior air film 0.17. Total Nt, 8.3 it 14, IM, - 1. Interior air film 0.68 2. " 3• 3 Va tsar��� roA /3.od_ 4. 'rh>- Sits �.oG 5. // r J, croK,' < 'r, , 7 6. Exterior air film 0.17' Total R, /7.D 3 • if r"W9 - (,-0 1. Interior air film 0.68 \ 2. 1 a ThfvlG /ate 3. 4. MDSon �� 7i�r, h4 ,/o 5. 6. Exterior air film 0.17 Total R. af, y / y •, a �g 1. Inte for air film 0.68 3. 4. 5. _ 6. Exterior air film 0.17 Total ?, /y, i5- ill �• //�l^ l �'• FIG: • #4 t ;- CSC I/! i NOT).': Indicate type, "?t" value, depth and placement of insulation. ROOF/CEILING e V Tr Vented Seat flow up FIG. #r5 Page 4 of 4 Construction -R-Value 1. Interior air film 0.61 2 .5/�� STI, . A 3. /� a "e1 /d� o r�/1m r s O�ety aH �J d, o 4. Exterior air film (still) 0.61 Total fl . d3,79 U, o y7- 1. Interior air .film 0.61 . 2. s)r 4n�lt.o.• `N�.:; off! 1;^•'^-c�i_P, r ri 3. 4. Exterior air film (still) 0.61 Total R. 19, i 9 / n n n n n n n n nnn n f14n In 11 (1 f it ,©sa J Heat.flow up .•vented• _ _FIG. 416...... 1. Inside air film 0.61 _._ 2 . 3 ' t+ 3. a34_5�,�y 4. ell S. Outside air film 0.17 �,;'- ; j......=:• :�'� Total Note: Use additional sheets if more space is needed for details and calculations Hent £low up - PIG. 07 CITY OF FRIDLEY REFRIGERATION AND VENTILATION, , APPLICATION FOR POWER PLANTS AND HEATING, COOLING, C�- AIR CONDITIONING SYSTEMS AND DEVICES / J PARTIAL RATE SCHEDULE f Z RATE TOTAL Job Address GRAVITY WARM AIR: $12.00 $_ Furnace — Furnace Shell & Duct Work 7.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 4.00 $ — Repairs & Alterations each add. $500.00 MECHANICAL WARM AIR: $12.00 Furnace Shell & Duct Work to 100,000 BTU 4.00 each add. 50,000 BTU 7.00 Replacement of Furnace 7.00 Repairs & Alterations -up to $500.00 4.00 Repairs & Alterations each add. $500.00 STF1*1 OR HOT WATER SYSTEM: Boiler & Lines up to 100,000 BTU each addn. 50,000 BTU Boiler only up to 100,000 BTU each addn. 50,000 BTU OIL BURNER- to 3 gal. per hour each add. 3 gal. per hour GAS BURNER- from 100,000 BTU to 199,999 BTU (over 199,999 BTU see Fee Schedule) GAS FITTING FEES: 1st 3 Fixtures Additional Fixtures Gas Range to 199,000 BTU AIR CONDITIONING �? $12.00 $ 4.00 $ 7.00 $ 6.00 $ $10.00 $ 10.00 $10.00 $ x $ 3.00 S X $ 1.00 $ X $10.00 $ FAN HEATING SYSTEMS see Fee Schedule VENTILATING SYSTEMS ALTERATIONS $ REPAIRS state surcharge TOTAL FEE ROUGH INSP. REINSPECTION FEE Date ($10.00) FINAL INSP. Date APPROVAL FOR PERMIT �/0K MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 $ Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein rdance City e specified agreeing to do all work in strict accodeclares that all the and rulings of the Department of Buildings, a d heretion are true and correct. by facts and representations stated in this app %—— , 19Z rJ� Fridley, Minn.q It— OWNER KIND OF BUILDING USED AS ���✓ TO BE COMPLETED ABOUT i ESTIMATED • PERMIT • NEW BUILD' G IT NO DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Size No. Trade Name Capacity Sq. Ft. EDR _ BTU HP Kind of Fuel Total Connected Load BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP ------' ,Durban t.,r Conditioni ,ung C46 Company C Osota 55432 Signed By V osis, t�linn Tel. No. C gn-84-9915051 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE.SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Nu---er Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ Water x $2.00 $ o x $5.00 54 C14 y p $ �y W w ��cp Water Softener Heater u u New Ground loan Old Building x N C�Q+ $ E •a ro la $ m ro N [L P4 N $3.00 $ Additional Fixtures 1.� j A ro 4 'y 'Y�7 N REPAIRS $ ALTERATIONS 8 (c� o J.) N N u N C1 v y4 $2.00 —t $4 ro ,� ro •.OI 7 N O O 4 .+ ++ N ro ro 7� ro -A rd .0 +� O as lec W v m wg m S a w y w u m a U 1St cor nec r ingo tad 3rd 4th (R) - Future Connection Opening Connected with Sewer (*) - New Fixture, Old Opening Water PARTIAL RATE.SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Nu---er Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ Now Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ 100;000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground loan Old Building x $5.00 $ Electric Water Heater - x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x $3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ 8.00 REINSPECTION FEE ($30.00) Job Address 6261 6 STREET NE ,? Department of Buildings 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 correc Fridley, Mn. 1-6-77 , 19 OWNER HERBERT EVENS KIND OF BUILDING ' frame USED AS TO BE COMPLETED ABOUT 1-13-77 ESTIMATED COST 10.00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. Compart�-) CZ119 612;0�� Signed By MIN NEGASCO Tel. No. ROUGH INSP. Date FINAL INSP. (g `Xi ^ ?- Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 SUBJECT PER City of Fridley 18501 A7 THE TOP OF THE TWINS BUILDING PERMIT RE COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 ; � CITY HALL FRIDLEY 55432 '.j NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/17/86 JOB ADDRESS 6261 - 6th. Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 Uplands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Herbert Evans 6261 - 6th Street N.E. 571-1684 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Home Improvement Inc. 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. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION Ij ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be the 2nd layer but not the 3rd. 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 S0. 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 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 $.88 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,765 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 R THE PERFORMANCE OF CONSTRUCTION. $29.50 PLAN CHECK FEE TOTAL FEE `- c� $30.38 SIGNATU RE OFC NTRACTOR OR AUTHORIZED AGENT IDA EI WHEN PROPERLY V IDATED THIS IS YOUR PERMIT 4LDG INSP �a7E SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEt NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] 1� R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: �( 974 - Legal / Legal Description: Owner Name & Address: �S Tel. Contractor: t-- Tel. Tel . #JF Address: 2'7®% c&7i )W Ig 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 [ ] Fit. Yd. Setback Side Yard Setback , �v Type of Construction:® �''®T� 9�- /��%7/jlC Estimated Cost: $ cf.sE �'y Approx. Completion Date: O Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: D APPLICANT:ZTel. # 2E7—/ -s CITY USE ONLY Permit Fee $ �Z Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ U Agreement Necessary [ ] Not Necessary [ ] TOTAL $ �U 3 y STIPULATIONS: 1 SUBJECT PE City of Fridley 218 AT THE TOP OF THE TWINS BUILDING PERMIT r ', R IPT O. _ COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BV 612-571-3450 910-F15 5/5/93 JOB ADDRESS 6261 6th. ST NE 1 LEGAL LOT NO. TRACT OR ADDITION SEE ATTACHED DESCR. 3 JBLOCK 1 UPLANDS 2 Cd ADD SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE MARX LOU EVANS 6261 6th ST NE Fridley MN 55432 571-1684 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 ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE xx 8 DESCRIBE WORK REROOF GARAGE 9 CHANGE OF USE FROM TO STIPULATIONS SEE NOTATIONS 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 1 ISTALLS 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 594 00 50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT A 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 18.09 SIGNATURE OF CONTRACTOR OR AUTHO ZED AGENT IDATEI WHEN ROP RLY VA IDA D THIS IS YOUR PERMIT 2 � S - 9� L G I SP DATE SiGNATUR FOWNEROF OWNERBUILDERI IDATEI NEW C l ADDN [ ] ALTER [ ] Construction Address: Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Owner Name & Address: Contractor: Address: Effective 1/1/93 Tel. # MN LICENSE # Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length GARAGE AREA: Length DECD AREA: Leeno OTHER: Comer Lot [ ] Inside Lot ( ] Type of Construction: Approx. Completion Date: DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. Ft. Yd Setback Side Yard Setbacks d Estimated Cost: $ T Driveway Curb Cut Width Needed: Ft. + 6 Ft = (Cost on Back) Ft x $ = $ DATE: ✓� _ �� APPLICANT: Tel. # .5� ZZ CITY USE ONLY Permit Fee $ 17,o 0 Fee Schedule on Reverse Side Fire Surcharge $ ♦ .001 of Permit Valuation (1/10th%) State Surcharge $ ♦ J�� $.50/$1,000 Valuation SAC Charge $ $750 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Con tors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: s /8, o I/ SUBJECT PERMIT NO. City of Fridley 28465 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. � COMMUNITY DEVELOPMENT DIV. r I PROTECTIVE INSPECTION SEC,2-0 1 CITY HALL FRIDLEY 55432 NUMBER DATE PAGE OF APPROVED By L 612-571-3450 910-F15 rV 10/28/98 JOB ADDRESS 6261 6th Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 lUplands, 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Marylou Evans 571-1684 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Westurn Cedar Supply 705 N. Rwy 169 Plymouth 55441 541-0304 20014207 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 QC REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (34 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 1 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 2913 $1.46 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVI IONS DF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRU ION OR THE ERFORMANCE OF CONSTRUCTION $74.75 Fir sC $2.91 z 2`R7Li PLAN CHECK FEE TOEE S 5 .12 SIGNATURE OF .11 iDAiE� CORACTOO EN O A 10 NISI$ Y UR PES SGN A TURE OF OWNER dF OWNED BU0.DERi IDATEI B G -NSP MATE NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: (e 2L ( (p -1:L . N E . Legal Description: Owner Name & Address: �UANJS Tel. # 5"7/ — Contractor: MN LICENSE Address: —70S N , LL!L)q L L 2 ,. rai Tel. # ` L1 _Q 3U 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: 25/ Construction Ty p�y �j �/�.� Estimatedest: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 6 C11 -t 2-9 99 APPLICANT: j Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ 'S, ck9 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 [ ]