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PRE 2010 DOCS. � City ®f Fridley Permit No. COQ AT TME TOP OF TME TWIN$ j� L. PLUMBING PERMIT APPLICATION S (L'-----•COMMVNITY DEVELOPMENT DIV. III �t i PROTECTIVR IM6AECT*M 0$PT. i r-•� ; CITY NASI iIsiMY $04$$ .....�.� .J 613-000•3400 NtAMM RCV. GATE PA$E OF ADP OV 0 Br 12/15/73 - 0 1 1 800 Job Address % 2Y .1-530 ner � le Ad ress oneaAel (,qsI �e s 7/05P RJ.umb,�' ng Cont ctor Address P one Kind of Buildi g^ Use Comp etion Date EstimatedCost �� ads T Plumbing Fixture Rates: NO. RATE TOTAL F - - --' ! Number Fixtures x $2.00 j Future Fixtures x-$1.50 �+ I ao"vA avo! to I i ! New Fixture -Old Open. x $1.50 O j Catch Basin x $3.25 ova 1.dl Water Heater -99,000 BTU _� x $3.00 ,3 •78IN I I i' I i Ground Run Old Bldg. x $3.25 'MNtval l I � I j ' Elec. Water Heater x $2:00 Gas Fitting Fees: l '3 c eNlvaol aoo,a •V8a3MONs I I i I ep •Q, I lst 3 Fixtures x $2.00 �• 4� lO � Additional Fixtures x $ .75 d 1"noal xNlac Gas Range -199,000 BTU x $5..00 U Repairs &-Alterations See I Description: Code • sNI>oYa I State Surcharge .50 SOM l l ! TOTAL FEE $'Z3 -50 NIVO I _e !The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work /1i901 in strict accordance with the City Ordinances and ruling MMAVM I l of the Department of Buildings, and hereby declare that all the facts and representations stated in this applLcation are tru and correct. 48 j 7- 7 M V Signature Date SUBJECT PE_094 City of Fridley(15 5 75--- AT THE TOP OF THE TWINS BUILDING PERMIT r ` O. ` COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r REV DATE 9/24/97 PAGE OF APPROVED BY CITY HALL FRIDLEY 55432NUMBER L J` 612-571-3450 910-F15 JOB ADDRESS 1530 73 1/2 Avenue NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 3 Jim Lund Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS 1, ZIP PHONE Jerry Sherck 1530 73 1/2 Avenue NE 784-6444 3 CONTRACTOR MAIL ADDRESS t`l ZIP PHONE LICENSE NO. Panelcraft of MN 3118 Snell -ng Ave`\S, Mpls. MN 55406 721-6628 2179 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. ,1 +I 5 EN NEERMAIL ADDRESS __,ZW 'w PHONE LICENSE NO. i 8 USE OF BUILDING l I' Residenti 1 y 7 CLASS OF WORK `°+ • 02 „17 NEW 0 ADDITI N 6 ALTERATION CJI REPAIR 0 MOVE 0 REMOVE 8 DESCRIBE WORK' Reside. House; Soffit & Fascia; Window & Door Trim 9 CHANGE OF USE FROM TO STIPULATIONS Install building wrap and have inspection of same unless manufacturer's specifications state it is not required. Install ventilation in soffits to meet the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S0. 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $12,573 $6.29 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- $199.75 Fir SC $12.57 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FE TOT L FEE e SC $5 0 $223.61 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI HEN RO ALIDA THIS IS YOW PERMIT D 9L INSP f1ATE S.GN ATURE OFOWNERoF OWNER BUILDER) IDATEI NEW (( Effective 1/,1/94 ADDN (( CITY OF FRIDLEY 1 ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R -Z Building Permit Application Construction Address: 1155C % t ---- Legal Description: Owner Name & Address:—a _ I �a__ Tel. # Contractor: ,C,-.��C�..--_-__-- MN LICENSE #_—C2- ---- Address:_��_.��--c�'��.- Attach to this application, a Certificate of Survey of the Iot, 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 t.DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot f I Inside Lot S/Ft. Yd Setback Side Yard Setbacks ��Type of Construction:0 W//TIS' (nEstimated Cost: $57Z . Approx. Completion Date: Driveway Curb Cut Width Needed: — DATE: APPLICANT: (Cost on Back) Ft. + G Ft = Ft x $ CITY USE ONLY Tel. # Permit Fee $ �Q10% 7_ Fee Schedule on Reverse Side Fire Surcharge $ ja 57 .001 of Permit Valuation (1/10th%) State Surcharge $�n� $.50/$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge $ 6.`''° $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 $L Agreement Necessary Not Necessary TOTAL $ STIPULATIONS: SUBJECT PER City of Fridley 12,764 AT THE TOP OF THE TWINS BUILDING PERMIT t EC0. `y ....... COMMUNITY DEVELOPMENT DIV. �� r PROTECTIVE INSPECTION SEC. NUMBER REV. DATE PAGE OF APPROVED BY ��'--",j CITY HALL FRIDLEY 55432 L 612-560-3450 910-F15 10/17/74 JOB ADDRESS 1530 - 731s Avenue N_E_ 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Anoka 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same -7-ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING ReSidpntial 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK r x 401 Dwelling and. a 261 x 221 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. Provide a verifying survey before capping. No occupancy permitted in any house in Jim Lund Estates until plat is recorded. Haven't received as-builts from Town & Country Surveyors - Contact Frank DeMa.rs 533-7340, for utility locations. 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 1029 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. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $24,156 12.03 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 PERFORMANC OFC ST RUCTION. $47.00 300.00 PLAN CHECK FEE TOTAL FEE 359.03 SI ATUREOFCONTRACTOROR THORIZED GENT IDATEI ENOALID D THIS IS YOUR PERMIT . 76A7 e�/� �/�•.r INVP l/O/ DATE / • SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEILOG APPLICATION FOR RES11)1:NTIAL,_,ALTERATION, OR ADDITION BUILDING �IERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: JAMES LUND CONSi,iINC• BUILDER: JAMES LUND CONST.PINC. ADDRESS: 2417 148th Ave NF Annka ADDRESS:2417 148th Ave NE Anoka NO:. 1530 STREET: 73.1/2 Avenue LOT: 3 BLOCK: 3 ADDITION: JIM LUND ESTATES E-10,5 CORNIER LOT: INSIDE LOT: X SETBACK: 35' SIDEYARD: W-22' 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: S;nLsle Family Dwellrgnt:24' Depth: 40' Height: Square Feet: --933 Cubic Feet: GARAGE Front: 26' Depth: 22' Height: 1;7'0S Square Feet; -4=7-2' Cubic Feet: Type of Construction: FRAME Estimated Cost: $ 32,000.00 To Be Completed: -_DEC. 9-1974 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: 10/9/74 SIGNATU`,�;��, (See Reverse Side For Additional Information,) he F 4:. FOR CERTIFICATE OF SURVEY T A \A C C 1 1 11►1 A 9oz 3 _ 1114 1w lopt —T1Y&W LO kn 0 (902.0) 82.50 9oz.4� I I o I T I 0' O I d I N ' I I � ® i -22 EPropose-a in Nouse N N 26 N � 21. .c os.o'• � f� i pro nage Vtil:ty Eascmcnt (900.0'• — — — —(901.0) N O Denotes iron monument (900) Denotes Existing Grade F9_0_051 Denotes Proposed Grade Proposed Top of Foundation -903.5 Notcl Description invalid until plat is filed DESCRIPTIONI Lot 3, Block 3, Proposed JIM LUND ESTATES-, Anoka County, Minnesota T /� I hereby certify that this is d true and correct representation of a survey of Job No. ��OLUi2 &1�0[tiZt/'y the boundaries of the above described land and of the location of all buildings, if any, thereon, and all visible encroachments, if any, iron) or on said land. Su rve ora -- Book P:3yr. Land Surveymy • Site Planning As s!nvoyed by me this _ __ —Tih- --day of civil Enyineenny 881610th Av N H 94 at B,.une Av. N.1 Brooklyn Park, MN 55428 ��tt��11 Phony 533 7340 Minn. Reg. No. __109`•I _ -- YrlIF6�LA Ce /UE.p "A - So /Z7r r000? 90 (?O-oVZo�C7' Z,14:':,� 7/� PURCHASE ORDER BY THIS DOCUMENT GOOD FOR PURCHASES UNDER $1,000.00 ONLY F52013 THIS NUMBER MUST APPEAR ON ALL CORRESPONDENCE SENT TO US SUPPLIER t'A !J 1� 2�9� ADDRESS I% rl I � CITY 1/ OF n / FRI D LEY PHONE N0. /� /� (o (po 6431 UNIV. AVE. N.E. FRIDLEY, MN 55432.4384 CONTACT 612-5714450 PRINTED ON RECYCLED PAPER. PAYMENT VOUCHER BY SIGNING THIS DOCUMENT BELOW I HEREDO AUTHORIZE PAYMENT AND THAT THE GOODS AND SERVICES HAVE BEEN RECEIVED OR RENDERED AND ALL CITY GUIDELINES HAVE BEEN FOLLOWED IN THE PROCUREMENT OF THE BELOW STATED ITEMS. /D-oi�/ � /f D C D PAYMENT AU ORIZW BY ACCOUNT OTY. UNIT PLEASE ENTER OUR ORDER FOR THE FOLLOWING UNIT PRICE AMOUNT Z2�e-/Jj)6 /% -,2S-S3s o2 00 93 SS u D -may- 1 lc �G ,/o -0000- 3a -696) >vi-ocoo-aoS_op lol- l -i L TOTAL . THIS AGENCY HAS AGREED NOT TO DISCRIMINATE IN HIRING PRACTICES ON THE BASIS OF RACE, SEX, COLOR, CREED, MARITAL STATUS, RELIGION, OR NATIONAL ORIGIN AND HAS AGREED TO TAKE AFFIRMATIVE ACTION TO RECRUIT MINORITIES AND WOMEN INTO EMPLOYMENT. IT ENCOURAGES FIRMS AND OTHER AGENCIES WITH WHOM IT PURCHASES PRODUCTS OR SERVICES TO DO LIKEWISE. WHITE, VENDOR - YELLOW, PURCHASING - PINK, ACCOUNTING - GOLDEN ROD, DEPT. HD. Since 1958( 3118 Snelling Avenue Minneapolis, Minnesota 55406 Telephone: 612/721-6628 FAX: 612/721-3136 To: Permit Department r—= Pareicrar"t of lL\iinnesota, Inc / Anji - Accounts Payable Re: Pe:—it refund request. Date: October 24, 1997 Panelcraft would like to request a refund for the following permit. Panelcraft will not be performing work at the address indicated on the permit. The job has cancelled as of October 24, 1997. Please send all refunds to: Panelcraft of Minnesota, Inc 3118 Snelling Avenue South Minneapolis, MN 55406 ATTN : Anji - Accounts Payable If you have any questions please feel free to contact me at (612) 617-2866. Thank you for your time. Sincerely, Annjanette Greiner October 24, 1997 V. ,A,p, ccams cm, pwoma . verMebm.ft Air Cend.MmIng SpUm md D(D G)RAVITT X AIM AM: RATE TOTAL. Furnace Shell & Duct Work ... ..... . $10.00 $ Replacement of Furnace 6.00 Repairs & Alterations—up to y300.00 6.00. $ 'Repairs & Alterations each add. 8300.00 300 $ Furnace Shell & Duct Work to 120,000 BTU ..$1000 ® � each add., 60,000 BTU . ......... 3.00 i 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. F.DR Steam x10.00 $ Furnace Shell. & Line --to 640 sq. ft. EDR Hot Water 10.00 $' Each add 200 sq. ft. EDR Steam Each add. 320 sq. ft. EDR Hot Water 3.00 $ OIL SURNER—to 3 gal. per hour 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to M,0'0D BTU) 6.00 $ p h over 199,000 BTU See Fee Schedule GAS BITTING FEES. No RATE TOTAL 1st 3 Fixtures X8 zoo $ � Additional Fixtures x ,98 Gas Range to INA00 a$ 600 S J� — - • i -:. �:l T H' �': ".ti's State Surcharge .50 4 see Fee TOTAL r Dept. of Bldg. rhmo 930-3480 L /�6_S ,,� — City of Fridley: The undersigned hereby makes application for a permit for the worm hereW. specified. agreeing to do all worm in strict accordance with the City Ordinancer and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Mon— Chvner C �� ,�� i7 '1- 2 Z Kind of Building Used as To be completed about, Estimated Coss, $ Ar 1_111z� 1 % Old—New. Building Permit No. _^_ Permit No. V' DZCCREMON OF WORK HEATING or POWER PIANTS--.Steam. Not Wa Warm A�No Trade NameL Ll 2-? Size No- / ©C� -Capacity----- — Sq. Ft E.D.R' BTU $? Total Connected Load % - 7 Hind of BURNER — TYade No `'v Zi�L size No v 667 6 CapaccitY 3q Ft ED R BT'U (om.-0m) 1600 - 9-3 a �I&ff . 560-3450 "j" City o r; [ea ANOKA COUNTY 6431 UNIVERSITY AVENUE NE January 16, 1975 FRIDLEY, MINNESOTA 55432 James Lund Construction, Inc. 2417 - 148th Avenue N.E. Anoka, Minnesota 55303 Re: Structural Finals on Homes in Jim Lund Estates Dear Mr. Lund: You have been requesting finals on the homes built in Jim Lund Estates. Upon making these inspections, we have noted that there are no door closers on the door leading from the dwelling unit to the garage. This is a requirement of the Building Code and therefore you must install them. Make sure that they are capable of completely closing the door as some that we have seen are not capable enough and do not close and latch the door. This is necessary to keep the integrity of the firewall between the house and the garage. We ask for your cooperation in getting these installed on all your homes prior to your requesting finals and those with people in and already finaled must be installed on or before February 7, 1975. Upon your completion of this request, would you please supply us with. the addresses of those installed in the homes that we have already make finals on so we can reinspect them. If there are any questions on this matter, please feel free to contact me at 560-3450. Sincerely, DARREL G. CLARK Community Development Adm. DGC/mh E e City of Fridley Applicaflan for PIUMMS end V -Mo g Pe it Dept. of B1dga. Phone SW -3450 DESCRIPTION OF WOnX Location �sc �� C �� Number, Kind and Locelioa of Fixtures .aV M O �i1 ►•gZ i Sii Zi Z New Ground Run Old Bldg......... x $33.25 $ Electric Water Heater..... _ ..... O` $ 7 :.AS FITTING FEES: N / N WATER NTR. GAS ELM $ 3 x $5.00 1 REPAIRS & ALTERATIONS—Refer to Code .50 State Surcharge °` Base Ist 2nd 3rd 4th Futu:e Coaaoctiaa Openings Conaectod with Sower t New Fixture, Old Openings 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 $ City of Fridley: The undersigned hereby makes application for a permit for the work herel specified, agreeing to do all work in strict accordance with the Citi 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 7 Owner Kind of Building -A - Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. Permit Ito. Signed / By Business Phune Na Water Beater 'Up to 99,000 BTU) • • • • x $3.00 $ ROUGH New Ground Run Old Bldg......... x $33.25 $ Electric Water Heater..... _ ..... z $2.00 $ 7 :.AS FITTING FEES: NO. RATE TOTAL Ist 3 Fixtures ............ • • • • • • x $2.00 ; Additional Fixtures ................ x $ .75 $ Gas Range to 199.000 BTU ..... ... x $5.00 $��` REPAIRS & ALTERATIONS—Refer to Code .50 State Surcharge Description ......................................... $ TOTAL FEE $Zo 9D SUBJECT P City of Fridley 27083 AT THE TOP OF THE TWINS BUILDING PERMIT Ir?` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 I ` 1 "'S CITY HALL FRIDLEY $5432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/10/98 JOB ADDRESS 1530 73 1/2 Ave NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 Jim Lund Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jerry Sherek 84-6444 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Nutzmann Bros Const 736 1 Ave628-0128 20043453 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 RX REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage (25 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Undrelayment must comply with State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 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 2085 $1.04 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL T E PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULA NG C STRUCTION OR THE PERFO ANCE OF CONSTRUCTION. $74.75 Fire SC $2.08 PLAN CHECK FEE TOTAL F E �I / r 8 SIGNATU F CONTRACTOR OR AUTHORIZED AGENT I T P OPER LIDAT BEOG I v IS IS YCWR PERMIT OA TE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] Estimated Cost: $ S ''? Effective 1/1/98 ADDN [ ] Ft. + 6 Ft = Ft x $ _ $ CITY OF FRIDLEY Tel. # 62P ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Permit Fee $ / 7 ' S Fee Schedule on Reverse Side Fire Surcharge $ . Uy BUILDING PERMIT APPLICATION State Surcharge $ OV ConstructionAddress: SAC Charge $ $1000 per SAC Unit License Surcharge $ S- Legal Description: Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ Owner Name & Address;_/.e,�,-.o Park Fee $ 5Ve e{ eiL Tel. # Contractor: ""u Tzm db ou' 4__.2 i- MN LICENSE # Address:� l=—T�ve. %�� Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EWROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction T e: �,�z_ rail Estimated Cost: $ S ''? (Fee Schedule o k) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 0 APPLICANT: Tel. # 62P CITY USE ONLY Permit Fee $ / 7 ' S Fee Schedule on Reverse Side Fire Surcharge $ . Uy .001 of Permit Valuation (1/10th%) State Surcharge $ OV $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ S- $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 $• 602 . STIPULATIONS: .».