PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N° 04 s
Date:
Owner:_ ' 1 ��'::=s may= 2�1 iLI� r !� Builder—
Address ____ Address —
OCAj�ION OFr BUILDING
No. Street—Part of Lot
Lot __ Blockt Addition or Sub -Division
Corner Lot _ ___ Inside Lot Setback. _ Sideyard.Nwor
_ _
Sewer Elevation __ _____ — Foundation Elevation
DESCRIPTION OF BUILDING.
ToAe Used r ,^`,' ..
Front ....Depth Height jL Sq. FLZA �� Ca
' FrontDepth _,,;%'ght - ,� Sq. Ft. p ` % Cu. Ft. r'{
Type Construction � ' Est. Cost .� .�� s� """' 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.
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, Nhnnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits aad this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. _ ri I
- Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to ase
the Building Inspector for separate permits for these Nems.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name L,�. Builder,=�:.w
Address Address
LOCATION OF BUILDING
No. Street Part of Lot
Lot Addition or Subdivision '��,0/_..
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
To be used as:
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 Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representations
stated inthisapplication are true and correct.
DATE SIGNATURE
(A Schedule of Fee Costs can be found on the Reverse Side.) ���
r
6t .
City of Fridley l �l
Apprication for Plumbing and Gas Fitting Porneit
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
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WATER HTR.
GAS
ELEG
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Base
1st
2nd
_
3rd
_
4th
• Future Connection Openings
Connected with Sewer
New Fixture, Old Openings
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ( x $1.50 $ • G C)
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTL) ...... — x 2.00 $--C-R Q
New Ground Run Old Bldg . ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures ..........................3 x $1.50 $�/�
Additional Fixtures x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE
Dept. of Bldgs. Phone SIIU 4-7470
Location lbin Gf
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. /
Fridley, Minn
Owner
Kind of Building T
4
Used as
To be completed about
Estimated Cost, $ ��
Old ew Building Permit No. 64 Permit No.
Signed F &L'jt"'
By _
Business Phone No &, j -�
ROUGH / ` Ll t- I
FINAL
az 2M 7-59
� 3 1
Application for Power Plants and Healing. Cooling. Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
Furnace Shell & Duct Work ..........................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 ..................
Repairs & Alterations each add. $500.00 ...............
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............
each add. 60,000 BTU .......................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 .................
Repairs & Alterations each add. $500.00 ..............
STEAM or HOT WATER SYSTEM
RATE
NO RATE TOTAL
TOTAL
8.00
$
Additional Fixtures .................
5.00
$
Gas Range to 200,000 BTU ...........
5.00
$
AIR CONDITIONING
2.50
$
FAN HEATING SYSTEM
See Fee Schedule
Capacity
�'
8.00
$
VENTILATING SYSTEM
2.00
$
ALTERATIONS & REPAIRS
5.00
$
5.00
$
OOSO-11 POST IM -12-58
2.50
$
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR 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
BURNER — Trade Name,Size
$
FAN HEATING SYSTEM
See Fee Schedule
Capacity
Sq. Ft. E.D.R S '>WmTU H.P.
. STDG CK HTG. & AIR-COND. CO
VENTILATING SYSTEM
1001 Xenia Av. &
$
ALTERATIONS & REPAIRS
TOTAL FEE
' S
A
REMARKS:
Dept. of Bldgs. Phone SU 4-7470
. e!;::,
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.
u�`ridley, MiW DEC 2 9 1960 195—
Owner.,_–�.i
Kind of Building
Used as ✓t
To be completed about
195-
195-
29 1961
4�
Estimated Cost, $_ df-® -
ew. uilding Permit No. 1_5®
DESCRIPTION OF WORK
HEATING
Warm Air—No—/
Trade Nam
Size
Capacity.
Sq. Ft. E.DD.R t� �� BTU H.P.
tel`
Total Connected Loa
_ Kind of Fue
BURNER — Trade Name,Size
No -Z-52 :2
Capacity
Sq. Ft. E.D.R S '>WmTU H.P.
. STDG CK HTG. & AIR-COND. CO
7D + 9 l
1001 Xenia Av. &
l
M' apoJiis 16, Minn.
Sioned—
oil
By
OOSO-11 POST IM -12-58
Business Phone No4
40 _00l 4P
D-56 .9113j�t.79
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS. MINN.
Weatherstrips, A.S.H.V.E. Construction No. Insulation
Guide
Windows I Doors Reference Out. =Wall Int. Wall Ceiling Roof Floor Kind T How. Applied
Ne—s—r—No Yes,NoI
Room r A
I F1.1 6� I Len2th x.' -�,' Width HeisEht I A Room I Lenixth Y Width ",J y Height
Windows and Doors—Crackage and Area
Glass
Width Height No. of Lineal fi. Area
of pane lights of crack sq. ft.
No. of pane —
4/3 1119
Net exp. wall
Int. wall
Coef.1 Btu
Coef.
Btu
Infiltration
Totalrtu.
? ,_1
Glass
Room I Length Width
Glass
Windows and Doors—Crackage and Area
Width I Height No Lineal ft Area
f pa f I
pane o pane lights
No. 0] : f of crack' q. ft
Exp. wall
%
Exp. wall
Net exp. wall
Net exp. wall
Ceiling
Int. wall
Floor
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 Room lLenffth '7 Width Height"
Windows and Doors—Crackage and Area
Glass
Width Height No of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
7,
Net exp. wall
Int. wall
Coef.1 Btu
Coef. 1
Btu
Infiltration
Totalrtu.
? ,_1
Glass
Room I Length Width
Glass
Windows and Doors—Crackage and Area
Width I Height No Lineal ft Area
f pa f I
pane o pane lights
No. 0] : f of crack' q. ft
Exp. wall
J
Exp. wall
Net exp. wall
Net exp. wall
Ceiling
Int. wall
Floor
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Room lLenixth Width J Height r
Windows and Doors—Crackage and Area
Glass
Width Height No. of Lineal ft. Area
No. of pane. of pane lights of Brack sq. ft.
7,
Net exp. wall
Int. wall
Coef.1 Btu
Infiltration
Btu
Infiltration
Totalrtu.
? ,_1
Glass
Room I Length Width
Glass
Windows and Doors—Crackage and Area
Width I Height No Lineal ft Area
f pa f I
pane o pane lights
No. 0] : f of crack' q. ft
Exp. wall
J
Exp. wall
Net exp. wall
Int. wall
Ceiling
Int. wall
Floor
Ceiling'
I Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I ,
Windows and Doors—Crackage and Area
Glass
Width HeightNo. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
7,
Net exp. wall
Int. wall
Ceiling
Coef.
Btu
Infiltration
Totalrtu.
? ,_1
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area
Room I Length Width
Glass
Windows and Doors—Crackage and Area
Width I Height No Lineal ft Area
f pa f I
pane o pane lights
No. 0] : f of crack' q. ft
J
Exp. wall
Net exp. wall
Int. wall
Ceiling'
Floor
Total Btu. / 0 6 �eo a
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Room I Length Width Height,, -
Windows and Doors—Crackage and Area
Width Height No. of Area
No. of pane of pane lights
Infiltration
Glass
j
Exp. wall ,�j
Net exp. wall
Int. wall
Ceiling
Floor
Totalrtu.
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area
Room I Length Width
Height 4'
Windows and Doors—Crackage and Area
Width I Height No Lineal ft Area
f pa f I
pane o pane lights
No. 0] : f of crack' q. ft
Coef. Btu
Infiltration
Glass
_
Exp. wall 4 v
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A Under area
City of Fridley, Minn.
BUILDING PERMIT
Date: - April 16,, 1971
Owner: Bruce Reveling Builder.
Address 181 -69th XX Avenue N.E. Address Same
LOCATION OF BUILDING
No. _ 1 _ � Street _ _ 69th Ayenu p- N _ F. _ _ _ Part of Lot
Lot 11Block Addition or Sub.Division . Rice Creek Plaza
Corner Lot _ Inside Lot —. X Setback — Sideyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
. 10980
To be Used as:
Remodel Basement Front _ Depth _ _ Height — Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Est. Cost —$.600.0__ To be Completed »Dee. j71
Call for a Rough In inspection before covering studs or ceiling.
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 a'A provisions of
ordinances of the city of Fridley. /P - e
In consideration of the payment of a fee of $_6.0.0_ , permit is hereby granted to Mrs. Reveling
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 andmoving of buildings
within � city limits and this permit may be revoked at any time upon violation of any of the provisions of d
ordinanCLARENCE BELISLE
NOTICE:
M pensit does not cover the constrostian, huldiatian for wiring, phrmbing, gas heating, awer or water. Be ars to see
the Bofiding Inspector for separate permhs for these nems.
,.
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: J r ti C_ P0 tJ i R6 BUILDER: S e (Z C ✓r�o �. 1
ADDRESS: j -1 Yue N j ADDRESS:
c� I
NO • . STREET •
LOT: I I BLOCK: I ADDITION: (&- CRC
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.
(Lvn'c., L�I Ll r -C C -'Y1 0—,CC
l r
DESCRIPTION OF BUILDING
To Be Used As:
Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction r Estimated Cost: fii vo
To Be Completed:
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:' -/- IS- - '71 - SIGNATURE: '7 )t
(See Reverse Side For Additional Information.)
a
Q
• •� �' �1Address Phone
Wil% ✓.i�._.<_ / � i %div./
•
• . TBlding D41te
,I_ — w
GRAVITY WAR24 AIR: Heating/Power Plants Yl
Furnace Shell & Duct Work ..$10.00 $ Steam Hot Wat r Warm Air
Replacement of Furnace ..... .. 6,00
' Repairs & Alterations—up to E500.00 6,00
Trade Name OC
Repairs & Alterations each add. $500.00300 g___ Size No. v
NECM WARN AM Capacity Sq. Ft
D
rurnace Shell & Duct Work to 124,000 BTU ...... . ..$10.00 $ /jQ - EDR BTU Ton.
each add. 60,000 BTU
• ' ' ' ' ' . ' ' ' .. 3'U0 $_ Total Connected Loadu�l'"'""
Replacement of Furnace 6.00$
Kind of Fuel
Repairs & Alterations --up to $500.00 6.00$
Repairs & Alterations each add. $500.00 3.00 Burner
STEAM or HOT WATER SYSTEM- Trade Name
Furnace Shell & Lines—to 400 sq. ft. FMR Steam $10.00
Furnace Shell & Line to 640Size NO.
sq. It. EDR Kot Water 10.00 $_ s
Each add. 200 sq. ft. EDR Steam 3.00 $___ ._._. Capacity Sq.Ft
Each add. 320 sq. ft. EDR Hot Water 3.00 $
EDR BTU Ton.
OIL BURNER—to 3 gal, per hour 6,00 $
i over 3 gal. per hour -See Fee Schedule
CAS i3LTIiY4EA (up 40 123,t` tl L'TII) 5.00
over 159,000 BTU Sem Fee lichadule
GAS FITTING FEES. NO RATE TOTAL
1st 3 Fixtures x$ 200 $ e e d I
Additional Fixtures y •75 E
Gas Range to I99,M x$ 5.00 $ _
.50 State Surcharge
AIR CO:11DITY.01.11ING �
FAN HEATIi3G STSG- ,I See Fess SchodL1.10
VENTILATING SYS t M t JI
ALTERATIONS fe REPAIRS •TOT:aL
ROUGH
FINAL_ - %� i natu e
Yate
City of Fridley
Slt,Id&CY �Q� .
Permit No.
AT THE TAP OF THE TBIIN$
r
�
Lj
HEATING PERMIT
L"-----GOMMVNITY OEVELOPWENT DIV.
APPLICATION
1 i COTE( YIVE 1�'ccTlOti D%PT.
1 ,
CITY HALL FAIDLGV Q6 -C33
HVICE1114
AEV.
®AYE
PAGE OF
APPROVED By
.J 61$-660-3460
910-F17A
0
2/15/73
1 1
800
Job Address
L
r ® Address Pone
• •� �' �1Address Phone
Wil% ✓.i�._.<_ / � i %div./
•
• . TBlding D41te
,I_ — w
GRAVITY WAR24 AIR: Heating/Power Plants Yl
Furnace Shell & Duct Work ..$10.00 $ Steam Hot Wat r Warm Air
Replacement of Furnace ..... .. 6,00
' Repairs & Alterations—up to E500.00 6,00
Trade Name OC
Repairs & Alterations each add. $500.00300 g___ Size No. v
NECM WARN AM Capacity Sq. Ft
D
rurnace Shell & Duct Work to 124,000 BTU ...... . ..$10.00 $ /jQ - EDR BTU Ton.
each add. 60,000 BTU
• ' ' ' ' ' . ' ' ' .. 3'U0 $_ Total Connected Loadu�l'"'""
Replacement of Furnace 6.00$
Kind of Fuel
Repairs & Alterations --up to $500.00 6.00$
Repairs & Alterations each add. $500.00 3.00 Burner
STEAM or HOT WATER SYSTEM- Trade Name
Furnace Shell & Lines—to 400 sq. ft. FMR Steam $10.00
Furnace Shell & Line to 640Size NO.
sq. It. EDR Kot Water 10.00 $_ s
Each add. 200 sq. ft. EDR Steam 3.00 $___ ._._. Capacity Sq.Ft
Each add. 320 sq. ft. EDR Hot Water 3.00 $
EDR BTU Ton.
OIL BURNER—to 3 gal, per hour 6,00 $
i over 3 gal. per hour -See Fee Schedule
CAS i3LTIiY4EA (up 40 123,t` tl L'TII) 5.00
over 159,000 BTU Sem Fee lichadule
GAS FITTING FEES. NO RATE TOTAL
1st 3 Fixtures x$ 200 $ e e d I
Additional Fixtures y •75 E
Gas Range to I99,M x$ 5.00 $ _
.50 State Surcharge
AIR CO:11DITY.01.11ING �
FAN HEATIi3G STSG- ,I See Fess SchodL1.10
VENTILATING SYS t M t JI
ALTERATIONS fe REPAIRS •TOT:aL
ROUGH
FINAL_ - %� i natu e
Yate
suedEcr P NO.
City of Fridley
12359
AT THE TOP OF THE TWINS
BUILDING PERMIT//'(?
i �
`L -------COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION
!,
Y
r SEC.
1 I
= CITY HALL FRIDLEY 55432
IL----
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
, 612-560-3450
910-F15
10/17/73
JOB ADDRESS 181 - 69th Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
11
1
Rice Creek Plaza SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
MR. BRUCE L. REUELING 181-69th Avenue N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
ROBERT F. NORBERG BUILDER 3316 Hillsboro Avenue Norah
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
❑ NEW X ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK Cons .ruc,- a 181 X 181 Addition to Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPERATE PERMITS REQUIRED FOR WIRINGat
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
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
R-1
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
$6,190
3.10
DOES NOT P O GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVIS S OF ANY OVER STATE OR LOCAL LAW REGULATING CON-
STR TION OR THE PE ORMANCE OF ONSTRUCTION.
20,00
e
PLAN CHECK FEE
TOTAL FEE
. /
$23.10
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGE(DA )
WHEN PROPERLY DATED THI$ IS YOUR PERMIT +
BLDG )NSP DA-TE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
��
I'
7 APPLICATION FOR RLiSIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF F1t1UL1_:Y, \1INNESOTA
OWNER'S NAME: OR +- M RS ),, BUILDER: -r%69FRT. lam: a098C9f--�7tJ�Lv4oR,
®®R L u
ADDRESS: [ SI 6? _" Aer AJ. E. ADDRESS. -33/,6 40A& .
NO: . /?/ STREET: 10 A-0 A/
if-
LOT:- BLOCK: l ADDITION: /1 /eF7 �i}���,e l�Le��.�•
CORNER LOT: INSIDE LOT: SETBACK; SIDEYAFD;
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: ! Q Height 3'
Square Feet • 3 , Cubic Feet • 3 e
Front: Depth: Height:
Square Feet; Cubic Feet:.��
Type of Construction: 1V1—'. Estimated Cost: i
To Be Completed: V'6tl � ZC�
a,
Theundersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in st7tict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that ill the facts and representations stated in this application
are true and Corr,-ct.
DATE: CSL° -P` /2 -
(See Reverse
g.�
S IGNA`lURE:
Side For Additional Information.)
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2.5. For repairs or alterations to an existing structure, the fee shall be at the
^ate of $3.00 for each Five Hundred Dollars (6500,00), or fraction thereof in the
Z.
cost of all proposed work.
2.6. In no case shall the fee charged for any permit as set forth in Section 2 be
1 rano 3knn_/._(1(]_,
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SUBJECT
RMIT NO.
City of Fridley
AT THE TOP OF THE TWINS
i
BUILDING,
PERMIT
•
`
RECEIP
' COMMUNITY DEVELOPMENT DIV.
f PROTECTIVE INSPECTION SEC.
�'--1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF APPROVED BY
612-560-3450
910-F15
7/13/78
JOB ADDRESS 181 - 69th Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1]
1
Rice Creek Plaza
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Bruce Reveling 181 - 69th Avenue N.E.
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Custom Pools 701 E. Excelsior Avenue, Hopkins
933-2255
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
o
S NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 16' x 32'.Swimming Pool
9 CHANGE OF USE FROM TO
STIPULATIONS
See letter dated July 13, 1978 from Environmental Officer for
stipulations.
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
$7,000
$3.50
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
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. -
STRUCTIONOR HE PERFORMANCE OF CONSTRUCTION.
$42.00
PLAN CHECK FEE
TOTAL FEE
$45.50
IGNATUREdfCONTRACTOR OR AU 0RIZED AGENT (DATE)
HEN PROPS LY VALIDATED THIS IS YOUR PERMIT
7-
La�1"Icu-IJ
I I 113LOG INSP
,(Sys
DATE
SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE)
CITY OF FRIDLEY
APPLICATION FOR RESI ENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER:
Address: rl �7
BUILDER:
-7
Address:
Tel. No.
NO.: Street: 6g e- lV <
LOTp 11 BLOCK: ADDITION: _ _.OUR
Q�
CORNER LOT: INSIDE LOT: V"' SETBACK: SIDEYARDS:
Applicaht 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:
SU) YVItMp>/ Front: �� Depth: Height: _
Square Feet: Cubic Feet:
Front: Depth: - Height:
Square Feet: Cubic Feet:
Type of Construction: Sw,wlrol piS Poo Estimated Cost: $ d 00 00
To Be Completed:
-- Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired - $ $
(SEE REVERSE SIDE OF SHEET)
Theo undersigned hereby makes application for a permit for the work herein
speeified, 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
A re trueL correct. See reverse side for additional information.
BATE: 7d SIGNATUP.E:
-V
Stipulations:
iA-t Lt J �L-q 13, t9�g
rte; �th'f ..
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
TELEPHONE ( 812)571-3450
July 13, 1978
Custom Pools
701 E. Excelsior Avenue
Hopkins, MN 55343
..- Re: Swimming Pool Construction at 181 - 69th Avenue N.E.
Dear Sirs:
This letter is to make clear this departments requirements for the swimming
pool construction at the above address.
1. As indicated, one (1) skimmer approved by the National Sanitation
Foundation will be provided.
2. As indicated, two (2) inlets of approved design for fresh and/or
repurified water will be provided.
3. As indicated, a main drain of approved construction will be provided.
4. The filter and pump shall be approved by the N. S.F. and be of
sufficient capacity to provide a minimum turnover of at least two (2)
times in 24 hours. This department recommends a turnover rate of
6-8 hours.
S. A deck of at least three (3) feet wide, measured from the pool waters
edge, shall be provided which extends completely around all private
residential pools. Above ground private residential pools may be
provided with decking of a minimum size of 4 feet by 4 feet at pool
entry points and provided that such decking has the approval of the
City.
6. The diving area will be acceptable provided there is no overhead
obs truc tion.
7. Fencing or other effective means including but not limited to walls
or buildings, acceptable to the City, shall be provided to positively
control all access to public and private residential swimming pools.
Fencing shall meet the following criteria:
(a) The fencing shall prevent the entrance of children and be without
hand or foot holds that would enable a person to climb over it.
(b) The fencing shall be at least 6 feet high and entrances shall be
equipped with self-closing and self -latching gates capable of
being locked.
(c) Self-closing and self -latching devices shall be placed at the top
of the gate or otherwise inaccessible to small children.
(d) The opening between the bottom of the fence and the ground or
other surface shall be not more than four inches.
S. An automatic chlorinator should be provided with a suitable test kit.
9. All electrical and plumbing installations shall be inspected and
approved by the City Inspection Department.
Custom Pools
July 13, 1978 Page 2
10. All electrical lines must be greater than 15 feet away from the pool
surface. An alternative is to bury said lines.
11. The pool fill spout must be protected by a bacuum breaker.
12. Suitable safety equipment to include but not limited to a ring buoy
and rope that is 1i times the pool diameter, and shepherds crook pole
must be provided and maintained with the pool at all times.
Furthermore, these and any other requirements must meet the provisions of
the Fridley City Code, Section 115, Swimming Pools. The building permit
is approved contingent on final inspections and approval by the City.
If any questions or problems arise from this letter, please feel free to
contact me at 571-3450.
Sincerely,
STEVEN J. O 0
Environmental Officer
SJO/mh
CC: Mr. Bruce Reveling
181 - 69th Avenue N.E.
SUBJECT
P
City of Fridley
2 36 706!445
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV
_
r PROTECTIVE INSPECTION SEC
NUMBER
REV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
8/4/95
10B ADDRESS 181 69 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11
1
Rice Creek Plaza North Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Bruce Reveling 181 69 Avenue NE
571-1286
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 O ALTERATION JJ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Soffit/Fascia
9 CHANGE OF USE FROM
TO
STIPULATIONS
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
]
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
$1,250
$.63
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
$43.00
Fire SC $1.25
PLAN CHECK FEE
TOTAL FEE
44.88
SI NAT URE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPER VALIDATED THIS IS YPUR PERMIT
CA�
NATURE•F OWNER IIF OWNERBUILDER IDA E1
pLD INSP GATE
NEW [ ]
ADDN IT --
ALTER [)
Construction Address:
. - CITY -OV FRIDLEX::
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Legal Description:o�+ I
Owner Name & Address: 6 (fir
'Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
;XU (:.{C.. I " IC
,eWw _ f -
Effective 1/ 1/95
.... .,mss
Tel. # - S7 (r is
MN LICENSE # f
Tel. #
Attach to this application, a Certificate of Survey- of the
lot, with the .proposed construction drawn on it to .scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
.5 aprwf5 4 f4c �0,_
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbaclp
Type of Construction:
Estimated Cost: $ l 02 450
Approx. Completion Date:
`5.
(Cost on Back)
Driveway Curb Cut Width Needed:
Ft. 6 Ft = Ft x $ _ $
DATE: APPLICANT:
Tel. # rz
CITY USE ONLY
Permit Fee
$ ' (,1 ��
Fee Schedule on Reverse Side
Fire Surcharge
$ S
.001 of Permit Valuation (1 / 10th %)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$850 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:
sueJEcr
N
City of Fridley
26368
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r�
RECEIPT NO.
1 _ COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.
';
r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
6/26/98
JOB ADDRESS 181 69 Avenue NE
t LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11
1
Rice Creek Plaza North Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Bruce/Jean Reveling 181 69 Avenue NE
571-1286
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Renewal By Andersen 350 73 Avenue NE, Fridley, MN
55432 502-4777 20040630
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 10 REPAIR ❑ MOVE ❑ REMOVE
13 DESCRIBE WORK
Replace 8 windows in home with pocket insert windows
9 CHANGE OF USE FROM TO
STIPULATIONS
Install smoke detectors to meet the State Building Code - in each
sleeping room and on each level of house.
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 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
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
$7,125
$3.56
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 CONSTRUCTION.
PLAN CHECK FEE
TOT EE
Licens
$5.Y/152.93
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
EN RD
VALIDA I$ IS UR IT
BL G INSP
I
T1ATE
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
ADDN [ ] CITY OF FRIDLEY
ALTER [ SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: /� I ' ((� cl rqk U. Me It--),
Effective 1/1/98
Legal Description: f
Owner Name & Address:hyua, L kan Reve/m—b9.Tel. #-5r7 (-- f CC
Contractor: 6 , 0 ") d' I,q MN LICENSE #.DMLf OLO
Address:r ?� If 11 !E'i (� ���it� Tel. # `L{
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF FWPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
CI,
Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: �)�Q `� T& APPLICANT: &1z 4 'OL -6 A
Tel. #
CITY USE ONLY
Permit Fee
$ 139 Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1%10th%)
State Surcharge
$
$.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 [ J
TOTAL
STIPULATIONS:
SUBJECT
City of Fridley
26466
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
i
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
�39e;27�
1 �
1 . I
NUMBER
REV
DATE
PAGE OF
APPROVED BY
/" 11 CITY HALL FRIDLEY 55432
L J` 612-571-3450
910-F15
7/6/98
JOB ADDRESS 181 69 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11
1
Rice Creek Plaza North Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Gene Reveling 181 69 Avenue NE
571-1286
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Advanced Home Imp 1501 78 Ave N, Brooklyn Park HN 55444 566-0233 20017269
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
$1 751
$.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-
$
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALfAE
LiceSKJ%9
$5.00
$64.38
G I RE OFC OR OR AUTHORIZED AGENT J� IQAT
p QP
1. )DATE I$ IS PE=MJJ1
`UR
N .TURE OF OWNEROF OWNER BUILDER) (DATE)
NSP
DATE
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: � S 4 `Vii' ,,, t'_'
Legal Description:
Owner Name & Address: '$ c tQ, ct )®I'\ Tel. # -S"�
Contractor: 1AJ %- CA c -1-L'P 77 X-7.'4. MN LICENSE # o
Address:. % S� J ��" `a AIS Tel. #
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 IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
2/x 83,416
x? /7S/. a�
Estimated Cost: $
Construction Type:���- - ���-, —T�
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: APPLICANT: Tel. # 3-7 7-4 6a--'7-
CITY
�
CITY USE ONLY
Permit Fee
$ �j4* 7,�'
Fee Schedule on Reverse Side
Fire Surcharge
$ Z%
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ �_ 6Q
$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:
NEW CITY OF FRIDLEY
ADDIS! [ ] 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: .�0 �� i��l/E "'c' zi�� y
Legal Description:
Owner Name & Address:
Contractor:
Tel. #
N LICENSE#je5<-r
Address: ����7�.¢� ���� r.� ge Tel. #
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: Estimated Cost: $ �;(Ixa Z) o
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
DATE:�� 4a APPLICANT• Tel. #
Call (763) 572-3604 for Permit Fees Ifailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
CITY USE ONLY -
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1450 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 [ J
TOTAL $ / Q,3 • 5 STIPULATIONS: