PRE 2010 DOCS•
City of Fridley, Minn.
■■
Date:BURDING
T N? 6679
i
Address
-.
Address
ON F BUILDING
NO. ��� Street ,ot 00.
Lot Block Addition or Sub-Divisi
Corner Lot ._ Inside Lot _ _ _Setback 2 52
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
T U
Front Depth Height Sq. Ft. Cu. Ft
Fro Depth Height p��_�D Sq. Ft cu. Ft
Type of Construction �-Est Id4 °`'o 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 fo d comph'ap�ce with all provisions of
ordinances of the city of Fridley. �� e
O
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
Id
persononearound and upnd builddley, Minnesota regalocatiowthecitylimits and permit may be revoked at a�/ABY do of aay of the provisions of said
ordinances �Y
Building inspector
NOTICE:
M permit does not corer the construction, hutallalion for whing, phnnhing, gas heating, sewer or wrier. Be sora to we
the Building hjspadtor for separate pomits for these liana.
— . r
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME
ADDRESS ( ADDRESS
LOCATION OF BUILDING
No. Street: Part of Lot
Loth Block Addition or Subdivision
Corner Lot Inside Lot Setback Side Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
DES9KPTION OF BUIL%DIN
To be used as:
�%�rc✓ 0.
Front Depth ' Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction 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 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
(Schedule of Fee Costs can be found on the Reverse Side).
,r • is 0 • s
City of Fridley.,
Application for Plumbing and Gas Fitting P
Dept. of Bid Phi S 4-7470
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures Locatio
3
��
o�
80
5
<
(�'Jg
3
�U'
z
�p
R
N
WATER HTR.
GAS
ELEC.
Bas
,at
2nd
3rd
4th
• Future Connection Openings
e New Fixture, Old Openings
Connected with
Sewer
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ....... .............. x $1.50 G ^�
Future Fixture Opening ................ x 1.20 $ Q
New Fixture Old Opening ............... x 1.00 $
Catch Basin ...... .. x 3.25 $
Water Heater (Up to 200,000 BTU) ......—�lx 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
City of Fridley:
The undersigned hereby snakes applicatio for a permit for the work herei
specified, agreeing to do all work h strict a yordance with the City Ordinance
and ruling of the Department of Buildings, d hereby declares that all the fact
and representations stated in this appli are true and correct.
Fridley,
Owner
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old ew uilding Permit
ROUGH 74— 0
FINAL
-Ow4z 2M
Business Phone
1913
City of Fridley, .Minn..
•
BUILDING PERMIT
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Date: OCTOBER 52 1965
ROBERT W. ERICKSON
Builder
Address 565 - 57th Avenue N. E. Address
Fridley, Minnesota 55421
No.
SAME
LOCATION OF BUILDING
565 Street 57th Avenue N. E. Part of Lot
Lot 20 _ Block 8
Corner Lot _ Inside Lot .
Sewer Elevation
N° 8513
Addition or Sub -Division ____ Donnav's Lakeview Manor
—. Setback — Sideyard
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Car Port Front 17 Depth 25 Height 10 Sq. FL 425 CtL Ft 4, 25 0
Front Depth height Sq. Ft. Cu. Ft.
Type of Construction Est. Cost _ 1,000-00 To be Completed
VARIANCE REQUEST GRANTED BY COUNCIL OCTOBER 4, 1965 FOR SIDE LOT VARIANCE
FROM 5' TO 3' FOR
CONSTRUCTION OF CAR PORT.
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 Zolwith 21 provisions of
ordinances of the city of Fridley. o
In consideration of tate payment of a fee of $_ AM , permit is hereby granted to M W_
ERICKSON to construct the building or addition as described above. This permit is granted upon
the express condition that theSbuil
n, ffi all workdone in, aroundand upon saiing, or any part thereof, shall conform in aII respects to the y, Minnesota ithe citylimitsnt may be revoked at any time upon violation of any of the provisions of said
ordinances.
ALLEN G. JENSEN Building Inspector
NOTICE:
Uls permit den net eowr the condrudlon, houlldion for wbiag, Plumbing, as bsetlng, s wrsr or water. Be am to an
tbo sawl" imp"ier for "pude pwmhs for done Nems.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME S BUILDER
ADDRESS r- ADDRESS
LOCATION OF BUILDING
No. ��" Street�7Part of Lot
r
LOT BLOCK ADDITION OR SUBDIVISION
Corner Lot Inside LOT 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: ,�lvl 04-A' ►
Front /7, Depth Height /
Sq. Ft. # X_ e1— Cu. Ft. Al )_,("__ 6:
Front Depth _Height
Sq. Ft. Cu. Ft.
Type of Construction �/_
�l�i ''�, Estimated Cost 1 = 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 are true and correct.
DATE — 6?�` 6•,( SIGNATURE_2
(Schedule of Fee Costs can be found on the Reverse Side).
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�n S9�'y�N-S189 6uluuDld puD7
(jeamiomftalty Co.
6441 University Avenue N. E.
Minneapolis 21, Minnesota
_75-1
5' U.T[9liy 4 Did -A I N AGE F -P'S, I
Real Estate
Industrial and
Commercial Sites
Residential Lots
Custom Homes
INSURANCE
Commercial
and
Persgnal
Sunset 4-4395
Ijb�>,I*&�— 1061 v
PNor,P Gt)u, jwv
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Application for Power 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 $—BQ—'—
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MEC*. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $
each add. 60,000 BTU ....................... 2.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT WATER SYSTEM
NO RATE TOTAL
1st 3 Fixtures ......... .........
Furnace Shell & Lines—to 400 sq. ft. EDR Steam .....
8.00
$
*
$
Gas Range to 200,000 BTU ...........
Furnace Shell & Line—to 640 sq. ft. IDR 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
$
Gas Range to 200,000 BTU ...........
x 2.00
$
AIR CONDITIONING
$
FAN HEATING SYSTEM
See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS
TOTAL FEE
$�
ROUGH
FINAL
Dept. of Bldgs. Phone SII 4-7470
- 6r.., X/
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.
(JL Fridley, Minn 1963
Owner an
. _ n
Kind of Building r
Used as
To be completed about?�
Estimated Cost, $
Old—New. Building Permit No. _ Permit No. o2-
DESCRIPTI OF WORK
HEATING or PO PLANTS—Steam, Hot Water, Warm Air—No
Trade Nam Size No
100,
'-Capacity Sq. Ft. E.D.R BTU H.P.
uelBUTotal Connected Load 7S Kind of Fuel-
BURNER
RNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU A.P.
(REMARKS -OVER)
•
Signed
By SUP11-1Z.41114"',
8419
.42 2M susinessfVl�6��!!�f°CILIS 32, MINNESOTA
k ��VCV
HEAT LOSS- CALCULATIONS DEPARTMENT OF. BUILDINGSX g 3
Weatherstrips A. Guide E. Construction No.
Guide
WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind
Yes—No Yes—No 19—
F1.1 Room I Length ` Width Height ja / II 1 Fl.l _ _ Room I L
Windows ana Doors—Crackage and Area
.
Coef.1 Btu
Width Height No. of Lineal ft. Area
No. of pane of pane lights oo{f crack sq. ft.
D- Y�
f
/ r / r
Pro /r jw, 1, 0
Infiltration
Glass
Exp. wall
Coef. Btu
Infiltration
DO
Glass
d
Exp. walllea
a --
Net exp. 'wall
Int. wall
4a /zzo
Ceiling Ayh
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
1 F1.I MXoom I Lensfth tel/ /idth it/64 Heiaht 010
Windows and Doors--Crackage and Area
.
Coef.1 Btu
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
2 .o 0
f
/ r / r
Pro /r jw, 1, 0
Infiltration
Glass
Exp. wall
Coef. Btu
Infiltration
&I
Glass
d
Exp. wall
Net exp. wall
Int. wall
a --
Ceiling
gj;_
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins.;, W.A. Leader area .
/ Fl.l 7:1 -7- _ Rnom I LenQtlt �c s'"� �lidth l% ".1 HeiQltt P
Windows Ad Doom—Crackage and Area
.
Coef.1 Btu
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
f
/ r / r
Pro /r jw, 1, 0
Infiltration
Glass
Exp. wall
12
Net exp. wall
&I
Int. wall
Ora
Ceiling
O 0
Floor
ITotal Btu.
Required sq. ft. E.D.R. or sq. ins.yWJL Leader area
No. of pane
IF Vi?
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Insulation
How
'd Width /"d Height
and Area
meal ft. qeea
crack e. A
Btu
Fl.l ngth / D ! Width 41 / Height �#
Windows and MoiszXrackage and Area
Width' Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Coef. Btu
Infiltration 1 X�
Glass
Ora
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W Leader area
FI -1 A*V- _ m I Length A /w Wldthl y A Heutht ��
Windows and rs—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of -pane lights of crack sq. ft.
Coef. Btu
Infiltration
Glass.
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu. p
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
City of Fridley, Minn. N° 10660
BUILDING PERMIT
Date: - May 22, 1970
Owner: Rnbext !ret Rri eksnn Builder Robert Johns= Cc=.=_QQ.
Address 96 - 57th Avenue N.E. Address _5801 Lyndale Avenue
LOCATION OF BUILDING
No. 565 Street 57th Avenue N.E. _ _____, part of Lot
Lot 2n Block S Addition or Sub -Division .—Donna Manor
Corner Lot _ Inside Lot _.._ % Setback —_ Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Basement Addn. Front _ _ Depth . _ Height Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Masonry Est. Cost $1200. _ To be.Completed 30 days
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 mpliance wi all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $9_DIl__ , permit is hereby granted to Robert W.
Erickson 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.
�y Building Inspector
HANK N RICH
NOTICE:
ibis pormit does not cover tbs construction, instaQation for wiring, plumbing, on beating, sewer or water. Be sure to we
the Building inweetor for separate penmhs for these amm
Lond,Plonning Minneof oAi
32.
&-0 Surwieyl�y '01"nesola
Soils TesMy E"NGINEE RINGS INC. slbwT d -COC -6
Civil b -Municipal I Surve
E,7 —Enyineers f
F,420srtgage Loan Survey
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-al6WIdS, ;fdny, f077 on-W&/rid. rJ51ryey'i Ma�w5A7 avznedyil* a flwr97eloaq nog; ,
--ed except IS The holder dfsA;770j4je or p7Y, Alper inlered OWNiedb
ra4f "T
, ThepurposeA qbk��74`
h 1,;,e5 or
-0 - - ,
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S. NAME:�obe_� Li, E.i-ICXS !) sal BUILDER:. \o bt Jo h ".S ® !J Ce*n6,VI/-
ADDRESS:-Q,5-
`-ADDRESS:- QS S7 t4 &e A C ADDRESS:. Be)/ �_)ehj nde_ tie -
NO:. STREET: -' %
LOT.. ® BLOCK: ADDITION : _Do !6J A/ A /y/ * )Ji-
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:
B se_Me,A�`_
Front: Depth: Height:
Square Feet: Cubic Feet:
Front: —Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost:
To Be Completed: 30 0,14 y/ s
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: .s-- c2 g 7v SIGNATURE:
(See Reverse Side For Additional Information.)
17J y r F9°.
•
`ti .- • ►y y . . r
Building
BUILDING
Permit No.: t
Inspections
RESIDENTIAL APPLICATION
Received BY -2
763-572-3604
CITY OF FRIDLEY
Date Rec'd:46
DATE 5"--745-0(0 YOUR E-MAIL ADDRESS G V -D l.(�!6@9(„��
'n. AWT
SITE ADDRESS ,56S S "] t'='y t � 121'lp1_ er,1
THIS APPLICANT IS:
OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME:
TENANT
ADDRESS: �, 'J^%"f . V E CITY �Q I D Com/
�
STATE Z
7
PHONE: / 3 — S% 2-- O (O
CONTRACTOR
NAME:
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: CITY
STATE—ZIP
WITH APPLICATION
PHONE FAX
PROPERTY TYPE
-)MINGLE FAMILY/NEW CONSTRUCTION SIZE�
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
PERMIT TYPE
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK )KSIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR REMODELING
DESCRIBE WORK BEING DONE: 1UPIPLaCrEw
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
Existing Floor Plan
PROPOSED SIZE:
❑ DETACHED GARAGE
2•
Proposed floor plan
PROPOSED HEIGHT:
3.
List of structural members to be used
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
*Offit
ADDITIONS.
& PORCHES SUBMIT:
❑ Aluminumb Trim
�
1.
Site Plan/Survey showing the existing structures
Other r 1 � c E1'i
L-j.E r J,6121 Fascia
and proposed project
WINDOWS
2.
Two sets of construction plans
IN EXISTING OPENINGS es ON, LOCATION OF WINDOWS
3.
Energy Calculations
OR FOR NEW OPENINGS -DESCRIBE
SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ 7G®® 00 OCCUPANCY TYPE
Permit Fee $ ( ?a ;LT See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Fire Surcharge $ -7-00 .001 times the total job valuation
Surcharge $ ,lj. .0005 x Permit Valuation Minimum $.50
License Surcharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1550 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 $ q! 715 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 which requires rev ew and approval of plans.
SIGNATURE OF APPLICAN O PRINT NAME��E Ce DV ISL 1� DATE S� L��-D
Building
$
BUILDING
Plan Review
Permit No: -2,0t0 -0 U0-
Inspections
Fire Surcharge
RESIDENTIAL APPLICATION
Received By %'
763-572-3604
$
d L10 .0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
CITY OF FRIDLEYerdE
B 19 2010
763-502-49/77 FAX
$
ft + 6 ft = ft x $22 = $
Erosion Control
$
$450 Conservation Plan Review
EFFECTIVE 1-1-2010
$
Fee Determined by Engineering
' _/(0 —
$
DATE Z6
YOUR E-MAIL ADDRESS
$
SITE ADDRESS 4 j�5—
�I
U
THIS APPLICANT IS:
OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME:
TENANT
ADDRESS: �v
CITY f ✓7 `i STATE
PHONE: �-�� 2— <C9 %ri � fS
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE #
EXP DATE
AND CERTIFICATE OF
ADDRESS:
CITY STATE ZIP
INSURANCE
PHONE
FAX
PROPERTY TYPE
� SINGLE FAMILY/NEW CONSTRUCTION
SIZE
❑ TWO FAMILY/NEW CONSTRUCTION
STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED
❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF
❑ DRAIN TILE
❑ DECK SIDING
❑ OTHER.
❑'SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: (n
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING
❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
1. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ VinylSoffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
t' Trim
l . Site Plan/Survey showing the existing structures
❑ Other_
V1 Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
FOR WINDOWS - PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION S A OCCUPANCY TYPE
Permit Fee
$
i 1 See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
L ` (. .001 times the total job valuation
Surcharge
$
d L10 .0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $22 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
1 1 y 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 on site; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT C----� C� PRINT NAME ( R 6 I/L'v;5t&_. DATE t? 116