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PRE 2010 DOCSof Fridley SUBJECT rE,City 2210 AT THE TOP OF THE TWINS BUILDING P E R M I T RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. 1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED B 612-560-3450 910-F15 6/29/73 JOB ADDRESS 581 - 53rd Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Vacated P rtion of J fferson Street/ North of 53rd Avenue SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mr. Irving 01und 571 - 53rd Avenue N.E. 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 ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct 36' x 28' Dwelling and 18' x 22' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a verifying survey before capping. Provide a hard surface driveway. Agreement signed for water & sewer. PERMITS REQUIRED FOR WOO, S'�PERATE AND SIGNS. 14EAT j%p,, PLUMBING TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 lOO8 2O 16O 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, $16,188 8.09 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- STRUCTION OR THE PERFORMANCE OF CONSTRYPTION. $45.00 $275.00 PLAN CHECK FEE TOTALFEE O�_1328.09, S`SGNATU CON ACTOR OR AUTHORIZED AGENT (DATEfH PROPERLY VALIDAT HIS YOUR PERMIT SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) BLDG INSP DATE e APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: "my/wo, 01 dJ � BUILDER • ADDRESS : , ��`"�� S�flCq; 1%x: /1/ /_ . ADDRESS: NO:. STREET: If /o�17' LOT:— BLOCK: ADDITION• CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: 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 s; r -�@ Front:Depth: 7 Height: .ale / Square Feet: 0; Cubic Feet: ? 1 c Front: _ �� Depth•Height• �U Square Feet; Cubic Feet;_ '? 9 C O Type of Construction: IWIA Estimated Cost; $ 17 O06. - To Be Completed: J .;�z g Ce 00\ / 7 c13 . V The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: SIGNATURE• U r� (See Reverse S i_de For Additional Information.) �, ., - p�..` ,q F �- ('47 h ,� TI jts uberiture, Made this...........................2nd.......day of ...................................... 19.73..... between.... I.rving..lt....p.laxod ... (Ibisband)... .an,d-Audrey.... E ....... ..lund... XWi£e)........................................................................... of the County of ............. Anoka ..... ................................................... and State of. ....... Mirenes.ota......................................................... , part..ieg. of the first part, and ........................ City ..•of••Fri•dley........................................................................................................... .......................................................................................................................................................................................................................................................... a 0m under the laws of the State of ..................... ?.1i.nnesota................................. party of the second part, municipal itnt0t1 j, That the said part.i.es., of the first part, in oonsideration of the sum of •4ne•••and•••No/•10x•••(1 b)••••and •••other••values••• received --------------------------- DOLuRS, to............................................................in hand paid by the said party of. the second part, the receipt whereof is hereby acknowledged, do............ hereby Grant, Bargain, Quitclaim, and Convey unto the said party of the second part, its successors and assagus, Forever, all the traet...... or parcel...... of land Lying and being in the County of .......................... noka............................................ and State of .Minnesota, described as follows, to -wit: A six foot drainage and utility easement described as follows: The North six feet of that part of the vacated Jefferson Street lying between Block 2 and Block 3 of Oak Hill Addition, and lying North of the South line of Block 2 extended West and South of the North line of Block 2 extended West. All lying in the plat of Oak Hill Addition located in the South Half of Section 23, `f-30, R-24, City of Fridley, County of Anoka, 'Annesota. The City of Fridley hereby accepts this easement for drainage and utility purposes. MARVI2' C. BRUNSELL--City Clerk AO STATE DEED TAX REQUIRED Cj n 19 t;� 9, - -21 bio fba[be anb to 9b01b dje ba lnC, Together with all the hereditaments and appurtenances there- unto belonging or in anywise appertaining, to the said party of the second part, its successors and assigns, Forever. 31n Xegtimonp Wtjertd, The said part ... .IES of the first part ha.ve..... hereunto set .......their. hand ... s. the day and year first above written. In presence of vv... �,rGl......... ...... �rC. r........... ........ ............................ .............. i Qy cO y b+ CO ti y `►, It chi -P,. ~' • ";4. ip fJ f a C Ik z M ce s.: P,, rA ■AA,\MVVb\;,A&A A AAAVMAA,*vNAAAAM1Mr OL61 'n 'aaa s3jldx3 •wwo3 f4unoa uolaulysOM ViOS3NNIW - 3118(d AHMlON ANVOInW •r 8311VM 61 ■ V\+V W VVwvwwvY x •Jarl ul Aawour ur Aq pamaaxa sr motet sur aqs uagm asn so) air ,a3oN aaS„ pasaarw saurl ntmiq aqL :asoH .................�..............a..................saa-2dra umszitemoo f1I�• (ese,PPd,£ySS 'ALL L61, . ^� L V kILI °fiqunop.............................................................. ....012 nd f iv.iox ' P&ft)'eAY AZTSIOA Iun I£ti9 .. AeIPIsd 9� IFJ P.................. ................... A9 a31�tl?3a StlM 1N3Wf1211SN1 SIHl OWN aaS) ........................................................................................... paap puv jov aa.q.................................... so a•irrvs (a;ON aaS) arffp977109xa ....��.....�lurl# 2-r9ypala2ouoiov pu.v................................................................................................................................................ `jug?II,n.I?su2 y`uzo.80.1oi aiLl paploaxa oq.?Z puv `uz p94z.Lasap..... ........................ .........s.uosaod "I oq of uazov y aero of (e.;IM) pmlo 'a AeApnd Ptw (Pu9gsnH) PunI�i 'H SuWI Va.cvaddv fillvuosaod `filunoj 2)? -Do .Loj puv uzzlqta............................................................................. ................. VOff 'D `aecL a.cofaq .............b,r........................................................ o ..................... £L �jrir..............�............................. PuZ s?eft u0 .ss g310uv `g�o�a�ui Jo 311214�0 0 x P P on City of Fridley Appli n fw md�bq cad Gum Mu"whqPwidt Dept. of Bldg*. Phone 960-3 DESCRiPTION OF WORKKJit 1— -7 Number. Kind and Location of Fixtures Locasm I3 a S i �7� O� gSzl=Soyj n 8 t� l; UT lTd z g V jj I . N WATER MTM. GAS EIEC. Base 1st 2nd 3rd Sth • Future Connection Openings I wnaeczea wua e New Fixture, Old Openings PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE x $2.00 Number Fixtures ..........• . • • • • . Future Fixture Opening ........... x $1.50 New Fixture Old Opening .....:.... x $1.50 City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct 61 Fridley. Minn ,.; / .T L" — �� 19_ Owner Kind of Sewer 0 Used as Cesspool 0 To be completed about Estimated Cost, $ TOTAL ew. Old uilding Permit No. Permit No. -�a.C) p $ Signe � _. By - - $,_ Business Phune No 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........... . _�_ s $2.00 $ --2-052 :.AS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures • • • • • • ....... • • x $2.00 Additional Fixtures .................. x $ .75 Gas Range to 199.000 BTU,. . x $5.00 ROUGH FINAL�� REPAIRS & ALTERATIONS—Refer to Code .50 State Surcharge Description .....................................• ..... ; TOTAL FEE $ SUBJECT NO. City of Fridley 13202 AT THE TOP OF THE TWINS BUILDING PERMIT 111.17 ECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 . i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 9/15/75 JOB ADDRESS 581 - 53rd Avenue N.E. 1 LEGAL LOT NO. BLOCK I TRACTOR ADDITION SEE ATTACHED DESCR. Vacated Jifferson Street North of 53rd Avenue N.E. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Irvincr Olund 581 - 53rd Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO, 6 USE OF BUILDING Residential 7 CLASS OF WORK EX NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 16' x 22' Garage 9 CHANGEOFUSEFROM TO STIPULATIONS provide a hard surface driveway. SEPERATE PERMITS REQUIRED FOR MIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 352 3520 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 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,604.80 1.30 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- $6.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL F./EEO w $7.80 7 SIGNATURE OFC NTRACTOR OR AUTHORIZED AGENT (DATE) HENPROPERLY VALIDATEDTHIS IS YOUR PERMIT A �,U 21 a I CLI/V/L) %d� BLDG INSP �I IIIIATE SIGNATURE OF OLI � ER IIF OWNER BUILDER) (DATE) APPLICATION FOR RESIDENTIAL,. ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAMEBUILDER: ADDRESS S�` 5r�� ADDRESS: NO:. S -S/ LOT : GSC'/'C� ADDITION : CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: 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: Front: Depth: ;;-I �2 Height: /U Square Feet: 3,S_c1 - Cubic • Feet : Front: "Depth: Height: _Square Feet; Cubic Feet: Type of Construction: Estimated Cost: $ ��o U �•gC5 To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in st-kict 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 Ore true and correct. DATE: / �r// S SIGNATURE: (See Reverse Side For Additional Information.) 0 N.C. HOIRI AND ASSOCIATES, 10C. 0 10130 CENTRAL AVE. N.E. (Hwy. 65) —BLAINE, MINNESOTA 55434 712 SOUTH MAIN ST. — CAMBRIDGE. MINNESOTA 55008 CERTIFICATE OF SURVEY: IRV I NG OLV ND 0.0 o.4. FENC E gyp. X9.90 4� tiq in 0 i 1\ 1 ,S_8 / " 53 C -D AvF_ - N. E. p CIVIL ENGINEERS LAND SURVEYORS' Telephone 784-5480 689-4798 3789 '205-5/10 '4T-DEN0_rES IRON LEGAL DESCRIPTION: Jefferson Street vacated lying South of the South line of Temple Terrace 2nd Addition and North of the South line of Block 3, Oakhill Addition, extended East- erly to the South line of Block 2, Oak- hill Addition, according to the duly recorded plat thereof. / 1 5' STANDARD OIL FA5ENM6NT I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE ABOVE DESCRIBED LAND, AND THE LOCATION OF ALL BUILDINGS, THEREON, AND ALL VISIBLE EN. CROACHMENTS, IF ANY, FROM OR ON SAID LAND. AS SURVEYED BY ME THIS ......... LL ...... DAY OF.........Apd.l..........................A.D. 19.....7 ...... �OdSF.�G V7M,o0 — /.�0/%3 ............. 4.11 HOIUM AND ASS ATE , NC. .... .�.ac................................. . �.... Minnesota Registration No. .....4447.......... in I --J -z2'- ,S_8 / " 53 C -D AvF_ - N. E. p CIVIL ENGINEERS LAND SURVEYORS' Telephone 784-5480 689-4798 3789 '205-5/10 '4T-DEN0_rES IRON LEGAL DESCRIPTION: Jefferson Street vacated lying South of the South line of Temple Terrace 2nd Addition and North of the South line of Block 3, Oakhill Addition, extended East- erly to the South line of Block 2, Oak- hill Addition, according to the duly recorded plat thereof. / 1 5' STANDARD OIL FA5ENM6NT I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE ABOVE DESCRIBED LAND, AND THE LOCATION OF ALL BUILDINGS, THEREON, AND ALL VISIBLE EN. CROACHMENTS, IF ANY, FROM OR ON SAID LAND. AS SURVEYED BY ME THIS ......... LL ...... DAY OF.........Apd.l..........................A.D. 19.....7 ...... �OdSF.�G V7M,o0 — /.�0/%3 ............. 4.11 HOIUM AND ASS ATE , NC. .... .�.ac................................. . �.... Minnesota Registration No. .....4447.......... 7 SUBJECT City of Fridley 33975 AT THE TOP OF THE TWINS BUILDING PERMIT I COMMUNITY DEVELOPMENT DIV. NL MT r PROTECTIVE INSPECTION SEC. 1 . i NUMBER REV DATE PAGE OF APPROVED BY i A ; "�;•� CITY HALL FRIDLEY 55432 ---. L J ` 763-571-3450 910415 10/16/03 JOB ADDRESS 581 53 Avenue NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kevin & Diana Chambers 581 53 Avenue NE 763-572-2048 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Tabor & Sons Inc 10547 Terrace Rd, Blaine, MN 55434 612-789-1902 20014248 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 & Garage (21 Sq) 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 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,431 $1.22 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 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $83.25 1 SC $2.43 PLAN CHECK F7 TOT FEE L. C 0 1.90 SIGNATUR OF CONTRACTOR OR AuTMORIZED AGENT IDATEI E P Y VALID THIS IS YOURI/RMIT BL G INSR qA SIGNATURE OF OWNERoF OWNER BUILOERI IDATEI 7 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: Legal Description: Owner Name & Address: Contractor: Address:_ 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 OTHER: Width Hgt/Ground Sq. Ft. Construction Ty e:Estimated Cost: $ Driveway Curb Cut Width eded: Ft. + 6 Ft = Ft x $ _ $ DATE: �` C� -O� APPLICANT: a i� Z_�Tel.<izz 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 $ $ .7 3 $ /- $- 1, go 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 $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] From: 6516331549 Page: 214 Date: 4/5/2010 3:34:38 PM Building UILDIN Peloiit No.: -- Inspections RESIDEN ' IAL APPLICATION Received Ply: 4—- 763-572-3604 C OF FRIDLEY Datetec'd: i 763-502-4977 FAX FFECTlVE 1-1-2010 DATE 5 !Q YOUR ,r ADDRESS tin hall 6C-r.%c-J D,Ad•�.r,+e ,V So�a C41ayti5 ce+i�r+ SITE ADDRESS 55 TM$ APPIACANT IS: R OWNER NTRA OR PROPERTY OWNER/ NAS TENANT ADDRESS: l Sa ., ii _ CITY STATE f4d ZIPJ5 QL1 PHONE: --set. --t �s CONTRAC`T'OR NAME: • r ide c :,r Lt.C. STATE LICENSE EXP DATE l ! SU13MlT A COPY OF YOUR STATE LICENSE CITY i STATEN ZIP AND CERTIFICATE OF ADDRESS: c� .S .tc� v INSURANCE PHONE I0 Q 3 1 176'x : FAX toy-(oQ-A4 w CONSTR I CIION SIZE ❑ TWO FAMILY/NEW CONSTRUC ON STORIES PERMIT TYPE C ADDITION CARAeWSHED .fWINP0WS O BASEMENT FINISH i OOF 13 DRAIN TILE ❑ DECK SIDING ❑ OTHERR VOM IING FOOL TYPE OF WORK: U NEW HOME CONSTRUCTIONC3 ADDITION ❑ MAINTENANCEIREPAIRL E3 RBMODEL1N0 DESCRIBE WORK BEING DONE: C --M +rte --1 1 nse- SIZE OF 1MPROVEMENT EN HEIGHT SO FT Q HOUSE 01 LY RASENIM41TRPiuIO001M SUMMIT: NUMBER OF SQUARES ❑ HOUSE & ARAGE I Eyalsting F1o0t Plan GARAGES QATTACH•) GARAGE 2. P::opo-d:flobrpinn PROPOSED SIZE:- _ ... 0 DETA GARAGE 3. Lin of stntctural members to be used PROPOSED RETORT: FOR NEW CONSTRU4`•IION INCLUDING DECKS, W2= O Vinyl 13300 ADDITIONS. & PORCk m Nuam T: 1. Site Plaaft0 ey showing the existing structures 11Aluminum0 ❑ Other ❑ Fascia 2. TwosM of uotion pleas W ,,,,rr�� IN EXISTING OPENINGS�fYes ONO LOCATION OFWS ✓ 3. Enecgy calawatim FOR WINDOWS—PRb?VIDE TI -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF S. de - i ca.V- MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & 1+ 14 TYPE OF WWJ]OW TO BE INSTALLED • 3QQMB OF W=OWV—" ALL FEE + ARE BASED ON VALUATION, IN UDING TO COSH' OF L*BOR AND 11f.!TERWA. - _ - (USING THE I"W .B.0 FEE SCHRAULE) TOTAL JOB VALUATION 5 11 t OCCUPANCY TYPE, Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Maim Charge TII1S IS AN I hereby apply for a building permit and I acknowledge conformance with the ordimances and codes of the City of I permit but only an application for a permit and work is nj approved plea in the can of all work which requires review SIGNATURE, OF APPLICANT See Back Page for Fee Schedule 65% of Building Permit Fee .00T times the total job valuadon .0005 x Pellmit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $2100 per SAC Unit (Plans to MWCC for determiwtiou) ft+61}= ftx$24=S $450 Conservation Plan Review Fee Determined by Engineering Agreetnei# uecessaty ( )Non Necessary ( ) A PERMIT -NOT VALID UNTIL PROCESSED ,at the information abovo; is complete and accuraYq; that the work will be in dley and with the Minnesota Corlstme ion Codes; tit 1 widelstand. this is not a to start without a permit on site; that the work will be in accordance with the id approval of pins, F + I 7f 'v^M5 �� YM°x .. v w`u. ,{sem �'� �y * tea. t< �`fi >'. �`'. s, alp .:�`n�, Sys } 'i n P sG -f h �f 'z �t r _ r v d�.�' . m ,rY' d` n. ,- tmG L ��,y: �3'�.1 I W.i" 1 s -_,o-S -}r'" a+ L .. 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