PRE 2010 DOCSr',,
BUILDING;!, PERMIT
Village of Fridley, Minn.
N°
Date.. . ..............................
ownerA
WOO•i►1
Address :'., ....... .........
2254
Builder........... .........................'.....
Address.........................................
LOCATION OF BUILDING
NO...... . Street . ........... . Part of Lot ........................
Lot ........ Block ... Addition or' Sub -Division
Corner Lot ....... .... Inside'Lot ......... ... Setback . .. j .. Sideyard' . �t-.
fa '' ............
DESCRIPTION OF BUILDING
To be Used as:
Front Depth ,F%eight f't.... Sq. Ft..:...... Cu. Ft.
4
.... Front . . Depth ... #eight :........ Sq. Ft. .... Cu. Ft.... .
Type of Conatructi r � � : ► . Fat Cost. . ... To be Completed f
In consideration
the proposed work i
ordinances of the vi
,I
of the issuance to me of a permit to construct the building described above, I agree to do
a accordance with the description above set forth and in compliance with all provisions of
Mage of Fridley.
.. .. ....r.: ...
In considerall of,the payment of a fee of $. �,•�,. . ,., permit Is hereby granted to '. �►;tr ... .
wm " construct the buildin�dfr'a@clition as described above. Thist��i�t, ?s� t upon
•the expi- � the person to whom it is &g anted and his agents, employees and workmen, in all work
dpne int around .an uppn said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota egarding location, construction, alteration, maintenance, repairand moving of buildings with-
in the village 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
sewer or water.
a
s not cover the construction, Insolation or alteration for wiring, pluming, gas heating,
sure to see the Building Inspector for separate permits for these Items.
.i i
•
0
0
City of Fridley, Minn..
BUILDING PERMIT
Date; September 11, 1969
Ile78-/
N9 10399
Owner: Mr. Jack Chambers guilder Western Construct!on
Addrm 55) -57th Avenue N.E. Address 3017 Lyndale Avenue South
LOCATION OF BUILDING
No. 550 street 57th Avenue N.E. _, part of Lot
Lot 16 Block 10 — Addition or Sub -Division _ Donn ey i s Lakeview Manor
Corner Lot _ Inside Lot X Setback --_ Sideyard
Sewer Elevation _ _ _ _ _ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front _ 24' Depth _ 26, Height 10_ sq. Ft 6A r Cu. Ft. 62110!
Front Depth Height Sq. Ft Cu. Ft
Type of Construction Frame Est Cost T$2,500.00 __ To be Completed 45 Days
Paved Driveway
In consideration of the issuance to me of a permit to construct the building described bove I agree to do
the proposed work In accordance with the description above set forth and in compliance th a�l provisions of
ordinances of the city of Fridley. /
In consideration of the payment of a fee of $-.2 - 00 , permit is hereby granted to Mel Hen d ri ok son
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
Fridley Minnesota dreugpaor saia�tion gcons
tryuctionn,, alteration, mteenoanncen pair amend mooviing oofnboildcinaofs
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
r
C A REN CE BEL I SLE
NOTICE:
M porno does not cover the construction, installation for whine, phunbing, gas heating, sewer or water. Be sero to no
the Building Inspector for separate permits for these home.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER IS NAME 0 BUILDER
ADDRESS Y 67C3 X57 7 aye IV l; ADDRESS .3 c I ? 07%0- -Ca
LOCATION OF BUILDING
NO. f -r o STREET .5 7
LOT 16 BLOCK / C' ADDITION OR SUBDIVISION V'C��L®
r
CORNER LOT INSIDE LOT E! SETBACK_ SIDEYARD____,
SEWER ELEVATION TOP OF FOOTING
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 4i Depth a6 Height d
Square feet a G! Cubic Feet
Front Depth Height
Square feet Cubic Feet
A
Type of Construction 4(>2,m41KQ, Estimated Cost J-, 0 O, a 0
To Be Completed d J'-
The
~
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 appl'cation are true and correct.
DATE o —! SIGNATURE'
(Schedule of Fee Costs can be found on the Reverse Side.)
0o
40
3
11
560-3450
ANOKA COUNTY
6431 UNIVERSITY AVENUE NE FRIDLEY, MINNESOTA 55432
August 28, 1975
Mr. Jack Chambers
550 57th Avenue N.E.
Fridley, Minnesota 55432
Re: Property Restoration
Dear Mr. Chambers,
As you are aware, a street improvement project is
currently under way in your area. Because of this con-
struction, a certain amount of restoration is required on
the individual properties affected. Our normal procedure #
of landscape restoration is too slope back on a yard where
a cut has been made at a maximum grade of 3:1. Because you
have expressed a desire to maintain the existing slope of
your front yard by personally constructing a timber retain-
ing wall, the City will furnish the materials for this
structure up to a value equal to the savings incurred by
such a construction.
Calculations performed by our Engineering Department
indicate that the money available for purchasing the
materials amounts to $205.00 for your lot. Based on the
price quotations for the various size of timbers and
measurements taken in the field on August 21, 1975, this
will purchase approximately 28 6"x6"x8' timbers at $6.50
each and 82 nails at $0.28 each. You will find a purchase
order for that total enclosed. The white copy is to be
forwarded to the vendor and the yellow copy shall be re-
tained by you and returned to the City upon receipt of the
materials.
This money is being made available for your requested
retaining wall with the mutual agreement to the following
stipulations:
1. The face of the wall shall lie a minimum of 5' from
the back of the existing concrete curb and gutter.
f
Page Two
To: Mr. Jack Chambers
From: Thomas A. Colbert
August 28, 1975
2. The property owner assumes and will perform any and all
maintenance and/or repair to the structure as needed.
3. The City, in its restoration stage of the street improve-
ment, will perform and provide the normal landscaping from
the back of the curb to the face of the retaining wall only.
Any landscaping along the side property line and driveway
will be performed by the property owner.
4. The material purchased by the City shall be used for the
construction of the retaining wall along the front footage
only of the lot in question.
5. All labor and materials required for the construction of
this wall will be provided by the benefited property owner.
6. This retaining wall shall be installed by September 15, 1975.
If not installed by this date, the City retains the right to
perform its normal restoration as directed by the Engineering
Department, and to disallow any claim for materials purchased
by the property owner for this referenced retaining wall.
If you have any questions or concerns regarding this agreement,
please do not hesitate to contact me.
s
Sincerely,
(i(
THOMAS A. COLBERT
Assistant City Engineer
TAC/as
Enclosure
SUBJECT
MIT
City of Fridley
19 6 3 9
AT THE TOP OF THE TWINS
BUILDING PERMIT
i
-
�
r`y COMMUNITY DEVELOPMENT DIV.
(j
r PROTECTIVE INSPECTION SEC.
�
1 �
V
`
I CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910-F15
8/19/88
JOB ADDRESS 550. - 57th Avenue N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
16
1 Lakeview Mayor kDo..nays)
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Scott Fldward Fuerstenberg 550 - 57th Avenue N.E.
574-0159
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 E� ADDITION ❑ ALTERATION O REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 24' x 26' Garage Addition
9 CHANGEQFUSEFROM TO
STIPULATIONS
Variance approved by Appeals Commission for 1,248 sf of garage area -
Council approval 6/20/88.
Provide a hard surface driveway.
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
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
$8,271
$4.48
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-
$108.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
LAN CHECK FEE
TOTALFEE
$112.48
'G NATURE OF COITRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERLY VACtDATED
THIS IS YOUR PERMIT
i'NATUREOF UERIIF OWNER BUILDER) (DATE)
BLDG INSP
np
NEW ] City of FYidley Effective 5/1/88
AMN [ ] R-1 AND R-2
ALTER ] Building Permit Application
Construction Address: ��,o r .S% /��
Legal Description:
Owner Name & Address: 5c074,11- %Jvl�Sf/✓ a� Tel. # S 17j11/s9
Contractor: __ 1q!S;re,1j.SC)k11 �1 S'� Tel. #
Address: -Fr Iwe j/ /
Attach to this application, a Certificate of Survey of the
lot, with the proposoed construction drawn on it to scale.
DESCRIPTION OF IMPRWIIMMT
LIVING AREA: Length Width Height sq. Ft.
GARAGE AREAL: Length Width 2 Height sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
SZr]3FH;.
Cbrner Lot [ ] I9nside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: wb6y IrY-4vYe Estimated Cost: 5 � 4C7 OC
Approx. Completion Date: _
Alt. A Alt.
`Proposed Driveway Width If New Opening Is Desired: $ 5
Width + 6' See Back Page
,�
DATE: APPLICANT: C' -moi Tel. # 97
Permit Free
State Surcharge
SAC Charge
Driveway Escrow
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ _ 0,_F
S
5
5
5
5
CLTY USE CILY
Fee Schedule on Reverse Side
$.50/511000 Valuation
$550 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
X1.4 .K 10, D0914AYIS LgotME d JA04ow A�3fltTi�t.�_
C-`E-COULTER & ASSOCIATES. INC.
wovaTlfau JC*M A. PETERSON
'LAND SURVEYORS Nu►RRAK R. LENZ JR, rTtu,a
wslMEss
^F. C/!Y LO►� .. .. IAlhl •YIIYEtI
A1GISTEREO.UMXR LAWS OF STATE OF MINNESOTA �wRr wort[
T4FOOMftlIIC, YwMYpo --,. NCtM 'EO MY P A M"S Of CITY OF MII.ME&POLSO 1YOICIAL
3''300 LYMDALE AVE. 50. iblNNEAPOLIS. MINN. 38408
- 024.0370
to - .. - �tttltepot'�c lttttiffuttt � � o� �
S77'L4 'AVE 1. woI
M`~ FiI •
.1404L r
1-5-F10
LA
-'
�.+ ool'''
Z4,(o6 9. 7 1lo
Ay�' SG4LF 1'�=301 . -
Qa' O
`�pp , • D! IO T'ES iitp l
log :40 pRoftsw
Lt - SA&Aal 1
y.f oy6b r1(9fAW�Dr O
�
` dot 16, dock 10. DOt*ky' - LAK£VrM VANOR ADDITION, Anoka COUnty, Minnesota, subject
�► to e0sements and restrictions sof record, if any.
. - i.hereby.`Ee1Yy that this survey, plan,'or
report sas prepared by me .or ur.8-er my
direct gape,#isiun and that�l am a duly
~' RtgistezVd Land Surdsyor uad®r .-the laws of -
;',.:'the State cf'11inne:so#a
-
DateP,�' ALR Re �o .,Q, K .
�•. a� 3'
i
CITY OF FRIDLEY Effective Date May 1, 1988
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
Gas Piping
(piping needed with new furnace)
Gas Range
Gas Dryer
* Air Conditioning (all sizes)
RATE
$ 20.00
$ 10.00
$ 10.00
$ 10.00
$ 10.00
All Others/Repairs and Alterations
18 of Value of Appliance or Work
COMMERCIAL/INDUSTRIAL
18 of Value of Appliance or Work
State Surcharge
TOTAL FEE
Reinspection Fee ($15.00)
Rough Insp.
Date
Final Insp.
Date
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00
PLUS $.50 STATE SURCHARGE
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
TOTAL Job Adares� 0/
$ Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
Cityof 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. TA Nu A 2 Y
OWNER A/0 G/ ,J/ A Y 0C) m 00d N! .e S
KIND OF BUILDING
USED AS g 6r 7—A i C_. -5-TO 10- 6
TO BE COMPLETED ABOUT /)'I A !� C K / P? O
ESTIMATED COST �l 4 D O O
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
RA-PZ-ACO nri /Roc F 1-011�': 19 AZ 2,.7- W 1 T- 14 (1.
o T -0N Q00FToP u",r S CS 6' fLp.vf�
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.
Trade Name
if 0 Size No. 16..5/ 13=�3—Z7D
�qea
Capacity Sq. Ft. EDR BTEb?) OX O HP
Total Connected Load Kind of Fuel P Ar G A S
BURNER - Trade Name
Capacity
Size No.
Sq. Ft. EDR BTU HP
Company J N L AI CC O /► ? 6r b
Signed By
Tel. No. 'or
Fill out back side for stack verification on replacement furnaces
4 1
CHIM14EY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1.
Has been carefully examined
Yes ()
No ( )
2.
Is free from rust or deterioration
Yes ( )
No ( )
3.
Has no foreign objects lodged within
Yes ( )
No ( )
4.
Is securely supported
Yes ( )
No ( )
5. Meets all current Code requirements for size and
total BTU connected Yes ( ) No ( )
6. Has Total heating BTU's of
All other BTU's
TOTAL
Remarks
Company
Signed By
Da to
.
SUBJECT
IT
Z
City of Fridley6
4 3 2
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
_ _ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
���
r
I �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
I = I---1 CITY HALL FRIDLEY 55432
A,
j 612-571-3450
910-Ft5
7/2/98
JOB ADDRESS
550 57th Ave NE
i LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
16
10
1 Lakeview Manor (DOnna %
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Lind 6540 Race Rd Fridley
571-6276
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
gzj�ftsrwm Siding 13570 Grove Dr #116 Ma le Grove 55311
689-0195 20093753
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
Siding, soffit and fascia
9 CHANGE OF USE FROM TO
STIPULATIONS
Install building wrap and call for inspection before covering. Install soffit
ventilation to meet 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
1 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMITQ
9Q
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PER I FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$56.75
Fire SC $1.80
®PLAN
CHECK FEE
TO ALFEE
4&_�s
Li C $5 0
64.45
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
E RO VAL
- -OG IN
D THIS IS YOUR PER
7�I
�iA E
SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY -AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 55-
0 - S_`7 ���� � Ovc� F2 L
Legal Description:
Owner Name & Address:
Contractor: &4mi
Address: —
Effective 1/1/98
Tel. #L c 6
smdv ` ow MN LICENSE # 37
Tel.# �9-/�/9.-
Atiach 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
GARAGE AREA:
Length
Width Height
DECK AREA:
Length
Width Hgt/Ground
OTHER:
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: �i jp�.; c7 , ���a o PffcA Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: 7 APPLICANT: Tel. #
TOTAL $
STIPULATIONS:
CITY USE ONLY
Permit Fee
$� e�S
Fee Schedule on Reverse Side
Fire Surcharge
$ Pty
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 0/0
` $.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ (
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $
STIPULATIONS:
Building
BUILDING
Permit No.:2601-0-0 v
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572=3604
DateffLm MAY 17 200
CITY OF FRIDLEY
DATE - /
YOUR E-MAIL ADDRESS Dlevi /
A'7!S' / CGrn
SITE ADD
fS
THIS APPLICANT IS:
❑ OWNER ONTRACTOR
PROPERTY OWNER/
NAME:Ch ja b ::S n e 4
TENANT
ADDRESS: 44c, 1522"'7 d4 L- P CITY IS'b/'AzSTATFA
LZIP-16-1� aj
PHONE: !Z 3 - 59zl — 2;,.? -
CONTRACTOR
NAME: ,,
SUBMIT A COPY OF
STATE LICENSE #e3 S( EXP DATE 3v %
YOUR STATE LICENSE
ADDRESS,40i6 0i6 Gi!! 7!'• CITY erbc STATES
WITH APPLICATION
PHO FAX
PROPERTY TYPE
WINGLE 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 ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: ,. �� tq vc, a 4 l 0L,.rr �
4 cl ��/u 0),ecJ
SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
J<HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1. Existing Floor Plan
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
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 OF WINDOWS
L FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
3(P SJR -fes ��Le. (USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee $ ` . �3 7 See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Fire Surcharge $ .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 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; that the work will be in accordance with the approved
plan in the case of all work w ' requires rev w and approval of plans.
SIGNATURE OF APPLICANT INT NAME 1-1114 ✓I; S DtA(446U /J4DAIM �`? Q