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PRE 2010 DOCSCity of Fridley SUBJECT PER 15113 AT THE TOP OF THE TWINS BUILDING PERMIT CEIPTN • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. J 1 i 1 �---1 CITY HALL FRIDLEY 55432 %j NUMBER REV. DATE PAGE OF APPROVED BY ---- 612-560-3450 910-F15 4/9/79 JOB ADDRESS 1309-11 73rd Avenue N.E. 1 LEGAL LOT NO. OCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 [6� 2 Evert' s Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tom Flynn 13300 Lily Street N.W., Anoka., MN 55303 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 427-6502 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. LICENSE NO. 5 ENGINEER MAIL ADDRESS PERMITS RCQuiREIT FOR WIRIN HEATING, 6 USE OF BUILDING PLUMBING ANU SIGNS. Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 48' x 24' Du lex'And a 28' x 22' Garacre 9 CHANGE OF USE FROM TO STIPULATIONS provide a hard surface driveway. Provide sod in the front and side yards. RAX Provide City with verifying survey before capping. SEWER LOCATION: (Off Central) 58.0' N.E. of Catch Basin, 18.2' S. of Power Pole Expose service to establish. top of footing. WATER LOCATION: (Off 73rd Avenue) 41.8' S.W. of S.W. corner of Existing house. 40' E. of Power Pole. DRIVEWAY DEPRESSION COST: Drive over curbing on Central Avenue. No depression cost if driveway is off Central. W'N6 THE CrM OF FRUEY DOES NOT GUAIRANTEE 711f Before digging call local utilities ACCURACY OF UTILITY LOCATIONS AND ELEVATIC: $. TELEPHONE -ELECTRIC -GAS Etc. THIS DATA IS FOR INFORMATION PUF:POSES ONLY AND. PERSONS USING IT SHOULD VERIFY THE INFORMATION REQUIRED BY LAVA' ON THE SITE. 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 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 2 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 $41,900 $20.95 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. $126.02 $850.00 PLAN CHECK FEE TOTALFEE $1,028.47 SIGNATURE OFCONTRACTO AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT 1 -c-. �.,DG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) �.. P] CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PEhMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER. ' BUILDER: Z& -7 / 1 • Address: Address: Tel. No. — Cs No. �_� 1 Street: puri !, - LOT: BI,OCY.: �- ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS: 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:_ Height: �® Square Feet: Cubic Feet: 25'3 4 Front: L2E Depth: Height: Square Feet: 61(v Cubic Feet: (01100 Type of Construction: ,,.�` Estimated Cost: $ p To Be Completed: — �� / Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired' $ $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side' for additional information. DATE: SIGNATURE: c ZP Stipulations: «► 31 �Sdy 1C. o o z 116.0'L P.C. 31. Sv SA•c. t'tl gSo, od . to tib , qr) 4` r109 9% !uPPr&m t-cvrL.L. 4Pjx 2;q wg'Z i Z L t3 8L44 2S:5"'Z C�cwu- �8�t I jso,� k 8 42 16 Z-B,C2Z = J6 y lo 2%( 41 q�r.;z Pin.,. �r 3� sod ,c �. o 3%. S O - �"� 41.9 #Zopso SAS- 2 X q'ta' gSo, od 11 1'' ,J lz [cJ'i- oc �DFF S�rv,c� fed 6F `/ / -4-7 D F IOD C- V® '17 S vytj .' f %%/!Oe��CPrr ro�e,,�6- AalmsL> A-)e O,AJ C?6--'1L-rTde /9 t - C®5 7- Q/&j iS CITY OF FRIDLEY APPLICATION FOR PLIMBING AND GAS FITTING PERMIT Job Address -130q— [ I Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct n Fridley, Mn. Is— 19 1-76_ OWNER J j:)0 KIND OF BUILDING USED AS TO BE COMPLETED ABOUT PARTIAL RATE SCHEDULE ESTI COST PLUMBING FIXTURE RATES: NO. .ro TOTAL o Number Fixtures x -H $ 3C-00 Water di to m A $2.00 $ H r. -+ m G] Signed By .14 VW $5.00 W � C Water Heater - to 99,000 BTU x Heater -,4 a s $10.00 e m E x�ao+ a H ce Ed a ROUGH INSP. ag u $ tiCj N G -i C 3 1st 3 fixturesx U -� o Date U $1.00 0 Gas Range to 199,000 BTU x $):0.00 $ APPROVAL FOR PERMIT JI&g .0 .0 First $100.00 $5.OQ $ .0 $2.00 $ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE State Surcharge M U a m to Ca 3 o W bei ,R� Cay U W Q 3 0 0 o as lee 1st 2nd 3rd 4 th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water Job Address -130q— [ I Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct n Fridley, Mn. Is— 19 1-76_ OWNER J j:)0 KIND OF BUILDING USED AS TO BE COMPLETED ABOUT PARTIAL RATE SCHEDULE ESTI COST PLUMBING FIXTURE RATES: NO. RATE TOTAL OLDNEW )BILDING PERMIT NO. PERMIT NO. Number Fixtures x $3.00 $ 3C-00 Future Fixture Opening x $2.00 $ Company New Fixture, Old Opening x $2.00 $ Signed By Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ Io.00 Tel. No. 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ ROUGH INSP. Electric Water Heater xDate $5.00 $ GAS FITTING FEES: -1,3"- FINAL INSP. � 1st 3 fixturesx $3.00 $ Date Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $):0.00 $ APPROVAL FOR PERMIT JI&g REPAIRS $ ALTERATIONS First $100.00 $5.OQ $ each add. $100.00 or fraction $2.00 $ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE State Surcharge $ .50 TOTAL FEE $SZ� REINSPECTION FEE ($10.00) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: BUILDER: ADDRESS: ,�� ' 1 ADDRESS: TEL NO: ���w� mac, �� TEL NO: Construction Location q6 L��3 STMET NO: STREET: �� ��_ /::7,z Ole LOT: BLOCK: _� ADDITION: -r Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Front: Depth: Height: Square.Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: To Be Ocmpleted: Estimated Cost: $ I Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: SEE REVERSE SIDE OF SHEET% 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: r% `117 SIGNATURE: Stipulations: SUBJECT PE City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir � • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC i ' S CITY HALL FRIDLEY 55432 NUMBER REV DATE P AGE OF APPROVED By j 612-571-3450 1 910-F15 10/7/94 JOB ADDRESS 1309-1311 73 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. I 4 2 1 Evert's Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ronald Pearson 784 Torchwood Dr, New Brighton MN 55112 631-3367 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 Duplex 7 CLASS OF WORK ❑ NEW ❑R ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Rebuild a 24' x 6' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 2 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 $1,175 .59 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 $29,00 Fire SC $1.18 PLAN CHECK FEE TOTAL FEE $30.77 I T EOF44 CON' ACT OR HORIZED AGENT (DATEi WHEN PPROPE VALIDATED THIS IS YOUR PERMIT % V SIGNA RE OF OWtjERFrOWNER BUILDER iDATEr OATS NEW { ] Effective 1/ 1/94 ADDN { ] CITY OF FRIDLEY ALTER(] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 G2Z1 Building Permit Application��3� `0,X Construction Address: -7-7&? f�VCL Legal Description: Owner Name & Address. N IN L-05'D�IJ Tel. # 31- �'3� 7 Contractor: -IZ t U7"3 C)s MN LICENSE # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. FL DECK AREA: Length 2 r Width r Hgt/Ground Sq. Ft. y r OTHER: ,v. (:5 X 2 tf ' ar- v -- Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction-7—\�l Ayt. Estimated Cost: 41 Approx. Completion Date: /e9/U (Cost on Back) Driveway Curb Cut Width Needed: = Ft x = $ DATE: f6) -'7 - 5F KAPPLICANT:-C�Tel. # TOTAL STIPULATIONS: $ ,30.72 CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $f - .001 of Permit Valuation (1 / 10th %) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $800 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: $ ,30.72 � I O-t— UOURBAN INC 21-h1JO b5 10 0 Land PN -11:9.. 51,337 Mortgage Loan Survey for ;7— zit 4� -:7 L r,?T This is a true and correct representation 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 mod. only' ;n'* connection with a mortgage loan now being placed on the pr ,perty and no liability is assumed except toholder of such m t or any other interest acquired by ;Ae reason of such mortgage. it is a e �Ih, - been pla ced for the purpose establishing I le Z*.�.gn at lines or boundary understoctd d agreed rn p f estabW corners. Doted Ihi-,Vf'p'dy of N ( INC. S ��,E E 191 -Mb, SUBURB Surveyors b 7 Not Published: All Rights Reserved � v1C)e,,- I I sueJEcr MIT NO. City of Fridley 26376 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. �7� _ PROTECTIVE INSPECTION SEC. ``�' NUMBER REV GATE PAGE OF APPROVED BY a CITY HALL FRIDLEY 55432 j 612-571-3450 91O415 6/29/98 JOB ADDRESS 1309-11 73rd Ave NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Pearson 1309-11 73rd Ave NE 631-8818 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Great Northern Resources 1942 U1 ssi78A-UI62 20117Q27 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 Tear off and reroof 311mse duplex (25 S) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 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 $1.04 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,085 DOE NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PRO IS NS F ANY OTHERSTATE OR LOCAL LAW REGULATING CON- Fire $2.08 STRU 10 PERFOANCE OCONSTRUCTION. $74.75 .5�.' �HE XSIGNATOR PLAN CHECK FEE TOT EE Lc e C $5. $82.87 OF OLCI.R".RAU�T..' EDAGENT tOATEi N PR PE BLDG 1 A DAT D IS IS YQUR PERMIT . + I' OATE S,GNATURE OF OWNER SIF OWNER BUILDERI IDATEi NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Ili' v� ConstructionAddress: Legal Description: Owner Name & Address: iso r �-e ci rte►... Tel. # Contractor: C s cs�� 1� -1 -A �� ��`� r c MN LICENSE # Address:-, 1ctLl � � x y,Ss « ( is L 4 /J ' �; Tel. # 7 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT C LIVING AREA: Length Lam_ Width 3 Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type:,C�� 1 Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: AtPLICANT: Tel. # T� -0 (O STIPULATIONS: CITY USE ONLY /'J ' Permit Fee $ /A/q Fee Schedule on Reverse Side Fire Surcharge $ o7-025 .001 of Permit Valuation (1/10th%) State Surcharge $ 1,04 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ � -00 $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 .$ LI). STIPULATIONS: Building BUILDING Permit No.:=q-�) 91 n Inspections RESIDENTIAL APPLICATION Received By:yk 763-572-3604 CITY OF FRIDLEY DaRE 9 763-502-4977 FAX 65% of Building Permit Fee Fire Surcharge EFFECTIVE 8-19-09 .001 times the total job valuation �,,, q 2" — / $ DATE/ 6'106 ( YOUR E-MAIL ADDRESS $ SITE ADDRESS ��©! - / C✓?` / a� — /V !Z Fn d It y W4) • 3 THIS APPLICANT IS: OWNER ❑CONTRACTOR $ PROPERTY OWNER/ NAME:r- a-cakvA.00 $ TENANT ADDRESS:/3D7— '3�- " P'C CITY P :✓t d F STATLOW°J ZIP S Fee Determined by Engineering PHONE: 7103 ' 7� — ✓�% $ CONTRACTOR NAME: $ V1.00 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❑ F ❑ DRAIN TILE ❑ DECK L�lSIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK:❑MEW HOME CONSTRUCTION 13 ADDITION MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 3 1 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT r3� SQ FTL!(fO ROOFING C'HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES O'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, Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum E I rim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ef.' ❑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: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ Z Soo — OCCUPANCY TYPE Permit Fee $ 25,R13 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ a,50 .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 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 $ V1.00 Make checks Davable to: Citv of Fridlev Attach Stiaulations 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 a)l work which 1 ires review and approval oftans. / / SIGNATURE OF APPLICANT PRINTNAME c� 1�Y r�L) DATE Z! lyd