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PRE 2010 DOCS0 0 City of Fridley, Minn. BUR DING PERMIT N® 3835 Date: ... - .... e! .. �......... . Owner �.. .. Builder ............... Address ........... Address ............................................. ATION OF BUILDING No. .. Street .. �l ♦�Q... ... A4.. ....... Part of Lot ................... . Lot .. .... Block ...%�.�............. Addition or Sub -Division Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ........................... DESCRIPTION OF BUILDING To be Used as: 4.�.A, Front /. �a.-. �� Depth �� � Height AQ t �f�Sq. Ft. :?�. Cu ,.3.5 .................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........ ..... Est. Cost... ® (�.. .... Completed ................... `ape of Construction .............. ,� To be Comp In consideration of the issuance to me of a permit to construct the building desribed 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. AX&V 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 with- in the city limits and this permit may be revolted at any time upon violation of any of the provisions of said ordinances. ...... Building Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners •Name kj cl_ A 1�� , e, Builder Sa,* Address .sit = •d f f1 v�.�.'l��' Address �•�• - LOCATION OF BUILDING No. Street dALfLA ,ev, Oybd•t of Lot Lot sr._.. Block YAddition or Sub. Div. Rjd*e CrpeX_T_Cpi• c e Corner Lot Imide Lot .&.etf_ Set Bach Applicant attach to this form Certificate of Survey of Lot and proposed bugding location. DESCRIPTION OF BUILDING To be used as Front U.,.t Depth7-0- AMY. Height 7 1200L gt&14 Sq.Cu. Ft. � Front _._.Depth Height Sq. Ft..__ Cu. Ft....:._:_.�_ Type of Construction v its Estimated Cost To be completesF & --------- The undersigned hereby makes application fora 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. t e Dater Signature 06 — (A•Schedule of Fee Costs can be found on the Reverse Side) City of Fridley, Mian.. BUILDING PERMIT o A s s o �-- Date: ....._ ..___ ._.._ Owner: ... _.°!.."� � °....._. � �.� .......,-`�!(, /Builder Address .....w/_.�/ ... _ _ r Address _..! ._.._ _ _.._..__...._ _._...._____._...... L C N OAF BUILDING No...... L.I.- Street � �._ l ,1��� r....___ Part of Lot ...--_.___._.__ � Lot ..... ....tom..._............ Block _...... -- .................. Addition or Sub -I Uvislon.._...� .2--._.. ?i .r._....-`✓ Corner Lot ..... . .......... ..._............. Inside Lot -......- q -----..............._...: ....._..--..... Setback ....._. ..:_.✓...._............. Sideyard -...- -_._.. Sewer Elevation_..._......._...._....................._....._............._......._...._............_........ Foundation Elevation DESCRIPTION OF BUILDING To IM Used a� / [/ nt .. Depth ' ....: Height ....:_ :�..._..._. ....:�" Sq. Ft.-�,i�,7._._. Cu. _.............. .............. _.... _.... o ..... _......... .._. eight ... Sq. Ft. ...... ................ Cu. Ft. ..................... Type of Construction -._� Depth ..:. _.....:..--- �,i 1 ..... � ...... Est. Co ._:.' .�)'�✓'e...... . 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 all provisions of ordinances of the city of Fridley. 4 - In consideration of the payment of a fee of $.--..._....... _... ...... permit is hereby granted to. .... .................................... ........_......._.. to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings withinrthe city city limits and this permit may be revoked at any time upon violatinof any of the provisions of said s / Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. CALMON a THIS PERMIT DOES NOT AUTHORIZE VIOLAT- 0 ION NY PRIVATE LAN® COVENANTS AND v.,, 1 i FdETRiCTItN% APPLICATION FOR BUILDING PS04IT CITY OF FRIDIEY, NMRMSOTA Mmer's Name Builder Address _7 l �e .Address LOCATION OF BUILDING No. a' Street aA"e "97,61 Part of Lot Lot . J Block Addition or Subdivision Corner Lot Inside Lot Setback Side -Yard SEWER. ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING Front Depth Blight Sq. Ft. Type of To be Completed Cu. Ft. C oZ, 0 0 0 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. G�v-u/ / DATE Z-/3- n � o SIGNATt� (A Schedule of Fee Costs can be found on the Reverse Side.) 5� • • City of Fridley, Minn. BUILDING PERMIT Date: June 9, 1965 N° '7'7'78 5rr �ci�663 Owner: David 4i7$gren Builder Kinahon Constriction Coo Address 512 66th Ave. N. E. Address 316 7th Ave* S. Be LOCATION OF BUILDING No. 512 street 66 Ave! N. E. Part of Lot Lot 5 Block 4 Addition or Sub -Division Rice Creek Terraces Plat 4 Corner Lot _ Inside Lot Sewer Elevation Setback Sideyard Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height Sq. Ft. Cu. n Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. Cost 16.,000-9-0--- To be Completed Storm damage repair In consideration of the issuance to me of a permit to constru. L- building described above I agree to do the proposed work in accordance with the description above/ hand in ,cOm� nce,with a provisions of ordinances of the city of Fridley. I In camdderation of the payment of a fee -,of $.10..ffi , permit is hereby granted to Loren Kindwn Const to cronstruct the building or addition as described above. This permit is granted upon the express condition tlat;�the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upoi :said building, or anypart thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regNrrliag 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 Allen Jensen Building Inspector NOTICE M permit don not caner the construction, huftHstton for wbhi& plmnbtna, On heattng, sewer or water. Be suns to as the Budding huposr tar separate permhs for these Itaau. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING No. ,6_1 �2 Street, Part of Lot LOT BLOCK ADDITION OR SUBDIVISIONS. 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. To be used as; DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Ccustruction ]��'�stimated Co 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 c rrect. DATE �� � STr-WATMV (Sched6le of Fee Costs can be A* . . . '04 ' ' � City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location 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 $ fA J (�9 d Z O • R f N WATER HTR. GAS ELEC. Base a $2,00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ 1st 2nd _ 3rd 4th • Future Connection Openings * New Fixture, Old Openings I Connected with Sewer Cesspool 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 .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................. ...............:..............$ TOTAL FEE $6. U0 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. Fridley, ` Minn /' Owner `'l 4b (,R0Aj Kind of Building Used as To be completed about Estimated Cost, $ �S c� -' Old ew. Building Permit No Permit No. Signe )o L�� G Business Phone ROUGH FINAL .? 5--4 4 42 19_ July UP 1970 61tV Gounail Fridley, Minnesota . Gentlemen s Res Deletion of Storm Seer gto,;ect - Iy=jl On Junco 139 19691 when we had the closing on the sale of our house and property at 512 - 66th Avenue NE, we agreed to put ssfides a sum of $1,591.71 to cover the assessment for street and water improvements being put in at the time. This included a sum of $212.34 for storm sewer on 7th St. NE. This amount is still being held in Fridley State Sank in our name and the buyers nsmes. As this storm sewer project has not yet been put in, we are asking that thio project be delated at this time ao our money can be released. It has been over a year since. the sale of our home and we feel we should no longer be responsible for any improvenonts decided La the f %urs. Tho street .and water assessments have boon paid in full as agreed and we would like to close this deal for once and all. Thank you for your consideration. Sinc®rely, C David F. Li lygrOi,��'4 Carol lie .l,ilygren (Wife) 13951 Uplander St. 10 Anoka, Minnescts 55303 Phones 427-1137 60 I SUBJECT PERMIT City of Fridley 20117 AT THE TOP OF THE TWINS BUILDING PERMIT i � rry ____ �.COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. �� �7", 1 r ` CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j 612-571-3450 910415 9/19/89 JOB ADDRESS 512 - 66th. Avenue N.E. 1 LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 Rice Creek Terrace Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Taylor 512 - 66th Avenue N.E. 572-3967 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Home Improvement 7401 Central Avenue N,E., Fridley, MN 55432 784-7543 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Reroof Residential Dwelling 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION CR REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof (2nd layer) 16 squares 9 CHANGEQFUSEFROM TO STIPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys 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 SQ. 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 1 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 $800 $ 50 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 PROVISIS F ANY OTHER STATE OR LOCAL LAW REGULATING CON- $21. QO RUCT ONO THE PERFORMANCE OF CON. j&I,- PLAN CHECK FEE TOTAL FEE JR 1 $21.50 SANRE OF CONTRA RORAUTHORIZEDAGENT (DATE) - W, EN PROPERLY 'PT BLDG INSP VALIDATED THIS IS YOUR PERMIT '91101A4 Z r)A SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI I NEW [ ] City of Fridley Effective 5/1/88 AMN [ ] R-1 AMID R-2 ALTER [ ] Building Permit Application Construction Address:— Legal ddress: Legal Description: Owner Name & Address: 721 Tel,. # (bntractor : J� �?�_�''� d� Tel. #-- Address: Address: 7qW l d, Attach to this application, a Certificate of Survey of the lot, with the proposoed construction drawn on it to scale. DESCRIPTION OF IMPROVEMEM LIVING AREA: Length Width Height sq. Ft. GARAGE AREAL: Length Width Height Sg. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Oc)nstructian:,-:! • dk - Alee Estimated Cost: Approx. Completion Date: w.� / Proposed Driveway Width If New Opening Is Desired: $_ Width + 6' DATE: APPLICANT ZJA�M— ISM4 1 '1 0; I M Alt. A Alt. B See Back Page Tel. # 701— Permit Permit Fee $ c2k 00 Free Schedule on Reverse Side State Surcharge $.50/$1,000 Valuation SAC Charge $ $550 per SAC Unit Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Flee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ cZ / . Sb STIPUIMIONS: sueJECT MIT City of Fridley ePE 0 4 3 4 AT THE TOP OF THE TWINS BUILDING PERMIT r _ COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. / 3 CITY HALL FRIDLEV 55432 NUMBER REV PAGE OF APPROVED BY 612-571-3450 910-F15 JGATE 6/20/90 JOB ADDRESS 512 - 66th Avenue N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 Rice Creek Terrace Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Barbara Taylor 512 - 66th Avenue N.E. 572-3967 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW .0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 101 x 16t Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations. on plan. WARNING Beforo digging call for all utility locations 454-0002 REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS 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 $1,150 $.58 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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 TOTALFEE $29,58 NATO EOFCON OR OR uT ZEDA ENT DATE I WHEN PROPERLY (DATED THIS IS YOUR PERMIT BLDG INSP f1A SIGNATURE OF OW IIF OWNER BUILD RI AT I NEW [ ] ADEN [ ] ALTER [ ] Construction Address: Legal Description: Effective 1/1/90 R-1 AND R-2 Building Permit Application Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION of nartavEmEn LIMU, AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 6c)x .a� L1191 - Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yawl Setbacks Type of Construction: Estimated Cost: Approx. Completion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: APPLICANT: Tel. # 5Z2 -,3'P6 % CITY USE ONLY Permit Fee $ 0[7. OC) State Surcharge $ --s$ SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOM$ �.� STIPULATIONS: Fee Schedule on Reverse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 3' 1 ij 3' Z44 --------------- 2X6 77 2x -./ I I "e I —) t-, VEAtc-e— 7)(L - Y -a I �) �— I IIql(I., x I � / �X lev SUBJECT City of Fridley 29860 AT THE TOP OF THE TWINS BUILDING PERMIT r E , REC . COMMUNITY DEVELOPMENT DIV. ♦ V ____ � PROTECTIVE INSPECTION SEC. r NUMBER FIEv DATE PAGE OF APPROVED BY ;.� CITY HALL FRIDLEY 35432 L 612-571-3450 910-FIS 7/12/99 JOB ADDRESS 512 66th Avenue NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 Rice Creek Terrace Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Strump571-4927 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Suburban Exteriors 9701 Penn Ave S St - 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 O ALTERATION KK REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof house and garage (20 S) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Buildingf¢ Code TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I 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 $1748 $.67 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- $63.15 1.75 STRUCTION OR THE PERFORM CE OF CONSTRUCTION Fire SC PLAN CHECK FEE TOT L FEE Licens 5 01, "rfCATUREOfCONTRACTORORAUTHORIZEDAGENT IOATEi E PR P Y VALID.ADM TNI$ I$ UR�IT r S,GNATURE Of OWNER,if OWNER SUILDERI IDATEI BL" INSP NEW[ l Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ SINGLE FAMILY AND DUPLEXES R-1 AND R-2 d BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: � a3kw Tel. #77 Contractor: MN LICENSE #—(4 Address: q m Ipz" Cleve. Tel. # 88j— 6-(23Q- Attach -(23a 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: Construction Type:��-kL'Q Estimated Cost: $�,Q ! Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: '� -/0 APPLICANT: /tQ,4,\ -, n ,4 . Tel. # CITY USE ONLY Permit Fee $ S Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ °� $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ . C) ® $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: