PRE 2010 DOCS0
•
City of Frill
BUILDING
Date: — June 19, 1967
ey, MiML 9320
PERNftT
Owner: _ Keith Ward Builder Keith Ward, International Blders .
Address 6281 University Ave. N. E. Address 3939 E 46th St.
LOCATION OF BUILDING
No. 870 .`... Street ___. 66th Avenue _ _ ___M. Part of Lot
Lot 1 _ Block 2 —Addition or Sub -Division .—Meadowlands Addn.
Corner Lot w X____ Inside Lot —.--- Setback 35' _ Sideyard 10' -- 35'
Sewer Elevation _
Top of Footing
To be Used as:
Dwelling Front
Front
Type of Construction ___ Frame
DESCRIPTION OF BUILDING
42' Depth 30' Height 21' Sq. Ft. 109 8 Cu. Ft. 23, 05 8
Depth Height — Sq. Ft. Cu. Ft.
Fit. cost 1_.2.L_000___^..... To be Completed Oct. 1, 1967
Approved by Mr. Wagner that the applicant -=Q= on his own risk.
Proceed with excavation on dwelling facing 66th, which would require
variance from required 25' to 15' as indicated on alternate "B"
survey dated October 1958.
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.
In consideration of the payment of a fee of $ 35.00 , permit is hereby granted to Keith Ward
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.
i' (�
CLARENCE BELISLE � Big Inspector
NOTICE:
This permit does not cover the construction, instaMen for wiring, plumbing, gm hosting, sewer or water. Be am to an
the Building Inspector for separate permits for them hems.
A.31"LI VIi i Xi FOR BUILDING aEMti tT
CIa:`i OF M-RaMMI� N; XNESOTA
OWNER'S NAME
ADDRESS /Q,a/ Z1 � c ''�"�? A ��C, E ADDP�ESS.�f -. .� S7`: gs /"' -
LOCATION OF BUILDING
NO. ? STREET t' � l PART OF LOT
LOT BLOCK ADDITION OR SUSDIVISI014,Ale"q1)4&� ),Al"jj
CORNER LOT INSIDE LOT SETBACKS SIDE -YARD �S
SEWER ELEVATION 4'3• :),("' FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building locationdrawnon these Certificates.
DESCRIPTION OF BUILDING
To Be Used Ad:
. .
Front s- Depth Height �P 1
Sq. Ft. Cu. Ft. _d 2 3.0 5-Y
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction ae_Z4 "Ar. ( 'Estimated Cost Z'�26 d
To Be Completed_ / ) 9 ?
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
('c dole of Fee Costs can be found on the Rederse Side).
City of Fridley
Application for Plumbing and Gas Rtting Permit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
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 $ 2.00
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $2.00 $
Additional Fixtures x $ .75 $
Gas Range to 199,000 BTU ..............
REPAIRS & ALTERATIONS—Refer to Code
x $5.00 $
Description ................................................
TOTAL FEE $
e
Dept. of Bldgs. Phone 580-3450
d
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 19_
Owner
I
Kind of Building a � J V
Used as
To be completed about
'� d®
Estimated Cost, $
Old—New. Building Permit No C�3 Permit No. /�.8 (fes
ROUGH 9 -It' L 7
FINAL
P
Signed
By
Business Phone No
N
8Z
% o
N
U
W
< 3
°1
W
�U' o�
0
?
O
i
P
+
N
WATER 14TR.
GAS
ELEC.
Base
Ilk
J,
11
1st
1
2nd
3rd
4th
• Future Connection Openings
New Fixture. Old Openings I
Connected with
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 $ 2.00
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $2.00 $
Additional Fixtures x $ .75 $
Gas Range to 199,000 BTU ..............
REPAIRS & ALTERATIONS—Refer to Code
x $5.00 $
Description ................................................
TOTAL FEE $
e
Dept. of Bldgs. Phone 580-3450
d
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 19_
Owner
I
Kind of Building a � J V
Used as
To be completed about
'� d®
Estimated Cost, $
Old—New. Building Permit No C�3 Permit No. /�.8 (fes
ROUGH 9 -It' L 7
FINAL
P
Signed
By
Business Phone No
IIX
r • .
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 ...........................$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 $
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures ...................... x$ 2.00 $
Additional Fixtures ................. x .75 $
Gas Range to 199,000 ........... x$ 5.00 $
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
$
See Fee Schedule
TOTAL FEE $
Dept. of Bldgs. Phone 860-3450
f 7'o 6 � ;tz (J64'r'
City of Fridley:
d�Q
1.
The undersigned hereby makes application for a permit for the work hereir
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 anc1Vyre&i,
Fridley, Minn 19 —
Owner
Kind of Building ' / `7 t Y,in
Used as �f
To be completed about =" y
Estimated Cost,
Old—New. Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS–Steam, Hot Water, Warm Air--'Xo
Trade Name !:/:�D C .0 A Size No
Capacity ®®®® Sq. Ft. E.D.R BTU �) Coo H.P.
JP
Total Connected Load Kind of Fuel d 1 L
BURNER— Trade Name
Capacity Sq. Ft. E.D.R. BTU H.P.
(REMARKS -OVER)
Signed
az Business Phone No
SUBJECT
City of Fridley
;Fi72691
AT THE TOP OF THE TWINS
PERMIT
r
BUILDING
CEIPT N .
`L COMMUNITY DEVELOPMENT DIV.
INSPECTION
?C21 9�
r PROTECTIVE SEC.
1 �
= CITY HALL FRIDLEY 55432
NUMBERREV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
18/23/74
JOB ADDRESS
870 - 66th Avenue N E
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
1
2
SHEET
1 Meadowlands
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Keith Ward 870 -
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Western Const
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residontial
7 CLASS OF WORK
E;A NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 24' x 22' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide a hard surface driveway.
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
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
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 PERMIT
$2,798.40
1.39
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 CONSTRUCTION.
$10.00
P ECK FEE
TOTAL FEE
$11.39
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
r
H N P OP
DG INSP
R V LI A ED THIS YOUR PERMIT
6AT4'
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME : / BUILDER:
ADDRESS : p %D G l �:� %/� �' . ADDRESS: &1 l' 9 e
NO:. 9;70 STREET: la '2% 4 L
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.
To Be Used As:
DESCRIPTION OF BUILDING
Front: Depth: Height: /24'
Square Feet: Cubic Feet: -1
Front: Depth:
Square Feet; Cubic Feet:
Type of Construction:
To Be Completed:
Height:
Estimated Cost: $ --J-760
r.
„a
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 •
(See everse Side For Additional Information.)
s
01 973-/
NORTHWEST OFFICE
4165 Hubbard Ave. North
Minneapolis. Minn- 55422
533-2126
DAVID C. BELL COMPANY
REALTORS • MORTGAGE BANKERS • INSURANCE • PROPERTY MANAGEMENT • APPRAISALS
Established 1880
July 8, 1974
To Whom it may concern!
The undersigned agree never to attach the garage being built
} at 870 66th Ave.:N.:E. to the house.
y�
l �V
BUYER
BUYER
SELLER
........... _. . .
SELLER
C
DOWNTOWN OFFICE SOUTHWEST OFFICE NORTHEAST OFFICE MINNETONKA OFFICE APAC1-1 vr.s•J.e OVI ICE
250 Midland Bank Building 3717 West 50th Street 3100 Johnson Street N.E. 13700 Way—ta Boulevard 37th & Silver Lis. Rd.
3
sueaEcr
PERM O.
City of Fridley
0 18114
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIP
�
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
1
/1 CITY HALL FRIDLEY 55432
01 1'j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
7/17/85
JOB ADDRESS 870 - 66th Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
2
Meadowlands Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dennis Digeros 870 - 66th Avenue N.E.
571-0505
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
O NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 22' x 14' Garage Addition
9 CHANGE OF USE FROM TO
STIPULATIONS provide a hard surface driveway.
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
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
$3,754
$1.88
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-
$44.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$46.38
ORIZED AGENT IDATEI
eeKW4TURE OF CONTRACTOR ORD��
WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
QNAREOF
BLDG INSP
/
DAf
OWNER OF OWNER BUILDE IDATEI
3
NEW [ ] City of Fridley Effective 4/1/84
ADDN. f R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: ` 0 — & 6 /fie
Legal Description: �_m°T e LoCe 2 /L4 z
Owner Name & Address. ) j�FILIA-)J 5 D16495�OS F,70 - Tel. #
Contractor: S e� Tel. #
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IHPROVEMENT
Length Width Height
Length 2-2- Width Height
Length Width Hgt/Ground
Corner Lot Pq Inside Lot [ ]
Type of Construction:/ ST.dLL
Sq. Ft.
Sq. Ft.
Sq. Ft.
Ft. Yd. Setback Side Yard Setback
Estimated Cost • $
Approx. Completion Date: O e -r /9 ?S -
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: �� APPLICANT: � / Tel . # S'?� 0 -0�-
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ /V Q Fee Schedule on Reverse Side
$ 25% of Building Permit Fee
$ $.50/$1,000 Valuation
$ $425 per SAC Unit
$ Fee Determined by Engineering
nt Necessary [ ] Not Necessary [ ]
Lana planning stiflem 6675 Highway No. 65 N.E.
Land Surveying c • • ���� Minneapolis,
Chia Testing �'�19bleP?l61�� • Minn. 55434
Civil Engineering Telephone 764-6066
•
',Municipal Engineering Engineers & Surveyors Area.Code 614
Mortgage Loan 'Survey for MR. KEITH WARD
�1�6 TM AVENUE N.E.
UNE 1114
6 r�
SCOIe: ij^jh:30rjd-
LOT 1 , BLOCk 2
MEADOWLANDS ADDITION
ANOKA COUNTY
This is a true and correct ►tpres•ntation of a survey of the boundaries of the land above described and of the
location of all buildings, if any, thereon, and all visible encroachments, if any, from or on said land. This survey is
made only in connection with o mortgage loan now being placed on the property and no liability is assumed
Oxcept to the holder of such mortgage or any other interest acquired by the reason of such mortgage. It is
understood and agreed no monuments have been placed for the purpose of establishing lot lines or boundary
corners. Dated this UA day of Join A. 0- 191k- -- -.. _.•_
.0 a���uw ■u�
• panssT uoaq srq Xouudnoop 3o
S aangon,zgs plus puu !panssT
2 10 Aourdn000 .zo asn am n,
Vti
SUBJECT
PER
City of Fridley
2 302
AT THE TOP OF THE TWINS
BUILDING
PERMIT
______ COMMUNITY DEVELOPMENT DIV.
v
r I I PROTECTIVE INSPECTION SEC.
1 I
NUMBER
REV
DATE
PAGE OF
APPROVED BY
= CITY HALL FRIDLEV 55432
�'""" 612-571-3450
910-F15
7/23/97
JOB ADDRESS 870 66 Avenue NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
2
Meadowlands Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dennis Digeros 870 66 Avenue NE
571-0505
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
B & B Roofing 6760 Madison Street NE,
Fridley, MN
55432 571-0248 9042
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
Reroof Garage (13 Sq) Tear -off
9 CHANGE OF USE FROM
TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REOUIRED 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
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
$1,084
$.54
ETHER SPECIFIED HEREIN OR NOT. THE GRANT NG OF A PERMIT
N T PRESUME TO GIVE THORITY TO IOLAT OR CANCEL THE
PERMIT FEE
SAC CHARGE
R VISI NS OF ANY OTHER ATE OR L C LAWEGULATING CON-
$37.50
Fire SC $1.08
;DDCE�ITH
RUC ON OR THE PERFOR NCE F N RUC
s �
PLAN CHECK FEE
TOTAL FEE
License SC
$5.00
$44.12
SIGNATURE OF NTR CTOR OR AUTHORIZED AGENT'IDATEI
WHEN PROP
o
6
B G INSP
Y VA IDATED THIS IS YOUR PERMIT
T
FATE
_
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW [ )
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
M
Legal Description:
CN
a'42E e<
Effective l / 1 /97
4 XV7
Owner Name & Address: /J��I?�/S/�,C/�� S Tel. #�%/— a SD�j
Contractor: F)� U lW MN LICENSE
Address: �j7
4D0 Tel. #,571—c) 25�
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: �� SCI�J%%� Uf — ��r2 �� (c� T�-4y • D Fir
Construction Type:
Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut
Width
Needed:
Ft. + 6 Ft = —Ft,;x $ _ $
DATE�� `:0 -Z -Y Cf,7
APPLICANT:
Tel.
#
CITY USE ONLY
Permit Fee
$
3 9, S O
Fee Schedule on Reverse Side
Fire Surcharge
$
/, Q n
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$950 per SAC Unit
License Surcharge
$
S _ 66
$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: