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PRE 2010 DOCSCity of Fridley susaEcr PERMIT NO. ®1464 AT THE TOP OF THE TWINS BUILDING PERMIT f • COMMUNITY DEVELOPMENT DIV. g%E6 r PROTECTIVE INSPECTION SEC. ' 30 1- NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 J 812-580-3450 910-F15 4/20/78 JOB ADDRESS - 7A Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 1Marxen Terrace Second SHEET -7-PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dennis = Schroeder 3 .CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Korman's Construction 707 Columbia Blvd, Mpls. 788-7362 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS pdH%&AnO ftENSE NO. IANti ACGt�RAL'Y d1` URN. F" WpgALMM MMM ONLY 8 USE OF BUILDINGTMS OM 19 PERSOM USING R WOUW VERIFY mE INMRAAATI©N Residential 7 CLASS OF WORK ON me sm ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 44' x 26' Dwelling and a 22' x 24' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide trugs design and verifying survey by 5/27/78. Provide combustion air to furnace. Maintain minimum 30' front yard setback. Provide a hard surface driveway. Provide sod in the front and side yards. WATER LOCATION: 50' North of Manhole, 17' E. of Hydrant. SEWER LOCATION: Approx. 10' ESE of Water Service. WYE ELEV: 891.57 TOP OF FOOTING: 895.57 Minimum DRIVEWAY DEPRESSION COST: N/A SEVERATE PERMITS REW11 ED FOR .WIRING, 01111 10W ud ities Bebr�, �ig�ng ., .. 9 Etc. HEATING, PLUMBING:. AND�SIGNS. t�:���;-E1.ECYkic.GAS RVD'.lay,'� AW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 80 DAYS, OR IF CONSTRUCTION 1186+ 528 28,664 Tota 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 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. $41,675 $20.84 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- $ 114.66 $400.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. / PLAN CHECK FEE TOTALFEE $28.66 $564.16 6,&A1 URE0F>W2T TOR RAU RIZEDAGENT IDATEI P PERLY VALIDATED THIS IS YOUR PERMIT�7`�' III/ `�W�,HEN c6 BLDG. INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI Surveyors Certificate COMSTOCK & DAVIS, INC. Consulting Engineers and Land Surveyors 1446 County Road J, Mpls.,'Minn. 55432, 784-9346 Survey Of: Survey For: Lot 1, Block 1, ' Tom Marxen Marxen Terrace s ,\V- 19958 Pine Ridge Drive City of Fridley N' Anoka, MN 55303 Anoka County, MN x IL Vq I v 3 io call local utilities /Z ti l WWI dil g _ ELEC�t�IC - GAS Etc. TELEPHONE i LAW �E(�U1RE®� .r Description: Lot 1, Block 1, Marxen Terr , City of Fridley, Anoka County, Minnesota. Subject to easements of record, if any. THE CITY OF FRIDLEY DOES NOT GUARANTre THE ACCURACY OF UTILITY LOCATIONS AND ELEVATIO>;S. THIS DATA IS FOR INFORMiATIOm pUP.FOSES ONLY AtdD PERSONS USING R SHOULD VERIFY THE INFORMATION ON THE SITE SCALE: o I hereby certify that this survey, plan or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. 10832 9/21/77 3850 iv Reg. No. . Date Job No. Y fox d Z9/, 57 T,�26 cF f�„N�- 95-ys� <�� 94 Gtr fo kr a!:5, r` % oV //-/ d03z W G C I l'Y OF Fit I DLCY I'PPLIC/,,TIC?i; Foo RE'S H)ENTJAL BUILDING PERMITS At GJL- i', ALIisRATIONS, AriDITIUi�iS, OR REPAIRS) OBd1iER: /�/✓fs\�� d���'�/� F:UILD::I;: 'S h 70 7 COX zAA4 t6 rho.. /!v Street. 17 A� LOT: .. BLOCK:—.L—_ ADDITICr1: CON.LR L.)T I11SIDE LOT: _ s"TB'1CK: Jj9 SiDEYARDS: Applicant attach to this foi:m Zlio Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION' OF BUI LDI idG To Led As: Front: Depth : - Height: Square Feet: e6 Cubic Feet: t I'xont: Depth: Height: !� Square Feet: Cubic Feet: Type of C{instruction: Gd 1W �✓ F.stSrnated. Cost: $ To B Completed: '% # --L---` -7—ze Alt. Alt. B Proposed Driveway Wi -, If New Opening Is Desired $ $ (SEE P.>;VERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the stork herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Dc oarttnent of Euildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side additional inf: :.iatbon. DATE: li—y1 b `'� SIGNATURE: �,_ Stipulations: C28.eo` ao, 8y �/. 46 1. Address ' 66-0 93% E 2. Legal / i 1)jWx 72�r4 • a? n. -P C 3. Zoning - f •, 4. Lot Width S. BuildingWidth z O $ 6.. Front Setback 9a.e 7. Total Use f- g$ to 8. % Lot 'Coverage �— - 9. Easements 10. Variance. N1e4- ; 11. Soil .5Adp 12. Contractor • #z7'Q i /' 13 . ' Phone i8 8 14.. Architect 15. Drainage 6e- 11.1snergy Ashrae Utility Locations pecials Driveway opening:O< C7, -D Truss Design Combustion Air 22. ` 23. 24. 25. ` EY OF L 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 612)571-3450 May 22, 22, 1978 f Mr. Henry Korman Korman's Construction 707 Columbia Blvd. Minneapolis, MN 55418 Re: Change of House Numbers Dear Mr. Korman: It has been necessary for this office to change the address of the house you are constructing FROM 1650 - 73;1 Avenue N.E. TO 1641 - 7312 Avenue N.E. LEGAL DESCRIPTION Lot 1, Block 1, Marxen Terrace Second We have notified the various departments in City Hall and we hope you will change your records and indicate to the buyers of the property the address change. Sincerel RON HOLDEN Building Inspector RH/mh CC: Assessing Dept. Special Assessment Dept. Water Billing Dept. Engineering Dept. APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE $12.00 S each add. 50,000 BTU 4.00 S�— Replace=ent of Furnace rj GRAVITY ItiAR%i AIR: RATE TOTAL Job Address Furnace Shell & Duct Work $12.00 $ SIFAM OR HOT WATER SYSTL-�I: Replacement of Furnace Repairs & Alterations -up to $500.00 7.00 7.00 $ $ Department of Buildings Repairs & Alterations each add. $500.00 4.00 $ City of Fridley Tel. #571-3450 MECHANICAL IiAR%I •AIR: Furnace Shell & Duct Work to 100,000 BTU $12.00 S each add. 50,000 BTU 4.00 S�— Replace=ent of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ SIFAM OR HOT WATER SYSTL-�I: Boiler & Lines up to 100,000 BTU $12.00 $ e4ch addn. 50,000 BTU 4.00 S Boiler only up to 100,000 BTU 7.00 $ each addn. 50,000 BTU 6.00 $ OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 (over 199,999 BTU see Fee Schedule) S GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00' $ AIR CONDITIONING $ FAN HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS $ ,ALTERATIONS & REPAIRS $ State Surcharge $ .50 TOTAL FEE $ ROUGH IMP. REINSPECTION FEE Date ($10.00) FINAL I.HSP. K-16 -749 Date APPROVAL FOR PERVSIT MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE The undersigned hereby makes application for a permit for the work here -tri 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.. Fridley, Minn. T11= P_ , 19� OWNER _ Ale �c/..""cZ ;I Goig 8 KIND OF BUILDING �/ ve•. USED AS TO BE COMPLETED ABOUT ESTIMATED COST / O J (� OLD - NEW BUILDING PEP14IT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HLATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. / Trade Name (; I— _ Size No. I•L)JO Capacity Sq. Ft. EDR BTU HP Total Connected Load // Kind of Fuel 1,Z - r C_ BURNER - Trade Name L5 Size No. L/%14Z Capacity Sq. Ft. EDR BTU !G ®Od HP RAY N. WELTER HEATING CO. company 4637 Chicaaa Ave. Signed By Minneapolis, Minnesota 55407 Tel. No. ZS-�o / r CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures 1 x $3.00 In Future Fixture Opening _� x $2.00 u New Fixture, Old Opening x b+ $ Water m °� .ei Water Heater - to 99,000 BTO �S $5.00 ' .cin m $10.00 m ro s+ a w $ New Ground Run Old Building Heater .4v $ e x $5.00 $ GAS FITTING FEES: u w as c oe a $ �U Additional Fixtures x $1.00 $ v � w $10.00 a REPAIRS $ ALTERATIONS 8 m $5.00 $ u m m v $ State Surcharge $ .50 TOTAL FEE ro o a r°c a ro o as lec m v m ai v� w v� w u m a tai /3 1st 2nd 3rd 4th (R) - Future Connection Opening Connected with Sewer M - New Fixture, old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures 1 x $3.00 $ Future Fixture Opening _� x $2.00 $ b New Fixture, Old Opening x $2.00 $ Catch Basin �_ x $5.00 0 $ S-6 0 Water Heater - to 99,000 BTO x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x '$3.00 $ �U Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ 3�0 REINSPECTION FEE (510.00) Job Address 7 3 /( Z 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 app ation are true and correct Fridley, Mn. .2A , 19 /7.5/ OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. _ /! L3W`_ Company Signed By Tel. No. ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT A �162 MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLUS $.50 STATE SURGE o f August 16, 1978 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 66432 Mr. Henry Korman Koxman's Construction 707 Columbia Boulevard Minneapolis, MN 55418 Re: Final Inspection at 1641 - 73'h Avenue N.E. Dear Mr. Korman: TELEPHONE ( 612)671-3450 A final inspection was made on. August 15, 1978 of the above address and all items were completed and approved with the exception of installing sod in the front and side yards. We will expect this to be completed by September 15, 1978 when a reinspection will be made to determine compliance. If you have any questions on this item, please contact me at 571-3450. Sincerely, DARREL G. CLARK Community Development Adm. DG C/mh CITY OF FRIDLEY INSPECTION DIVISION Effective On Januar)►1,1999 6431 University Ave NE. Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES HEATING CO ANY k (, MINIMUM FEE FOR ANY HEATING/COOUNG/VENTILATION REFRIGERA71ON/AIR CONDITIONING PERMIT IS $25.00 Signed Byel No. '7 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved By Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACKSIDE FOR STACK VERIRCATION ON REPLACEMENT FURNACE written permission from adjoining property owner. JOBADDRESS Ayi✓ f'C , RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side Vent —Fill Out Back) CW-�% 1199t? i Gas Piping (Needed with new furnace, but $10.00 $ OWNER _DE N cS � � q c_o k) not replacement) Gas Range $10.00 $ BUILDING USED ASMc-- Gas Dryer $10.00 $ ESTIMATED COST —g�rj o t) PERMIT NO. 13 *AirConditioning — All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (UST ON BACK) 1 % of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) arm Air Trade Name 7 n Q S L f) & Size No.-- o.Commercial/Industrial Commercial/Industrial BTU T5 E 8 ®y HP EDR 1.25% of Value of Appliance or Work $ Fuel �sI RT . GAS Total Connected Load State Surcharge $ .50 Burner Trade Name Size No. DC7 .BTU HP EDR TOTAL FEE $ HEATING CO ANY k (, MINIMUM FEE FOR ANY HEATING/COOUNG/VENTILATION REFRIGERA71ON/AIR CONDITIONING PERMIT IS $25.00 Signed Byel No. '7 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved By Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACKSIDE FOR STACK VERIRCATION ON REPLACEMENT FURNACE written permission from adjoining property owner. List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CHMEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer * Air Conditioning (all sizes) All Others/Repairs and Alterations 1% of Value of Appliance or Work. COMMERCIAL/INDUSTRIAL 18 of Value of Appliance or Work RATE TOTAL Job Address 1641 734 Ave. NE $ 20.00 $ Department of Buildings. 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley $ 10.00 $ Tel. #571-3450 $ 10.00 $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Cades $ 10.00 $ ana rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. $ 10.00 $ 10.00 Fridley, Minn. April 24 19 89 OWNER Dennis & Joan Schroeder $ KIND OF BUILDING Frame USED AS Residential S TO BE COMPLETED ABOUT State Surcharge $ .50 TOTAL ISE $ 15.50 Reinspection Fee ($15.00) $ Rough Insp. Date Final Insp. Date Approval for Permit�r�l�/ ESTIMATED COST $2200.00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. /6/08— DESCRIPTION 6/0V DESCRIPTION OF FURNACE/BURNER "INSTALLING ONE (1) CARRIER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. 38TKO24 2 TON AIR CONDITIONERrade Name Size No. MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00, PLUS $.50 STATE SURCHARGE Attach stack verification form with replacement furnace permits *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Capacity Total Connected Load BURNER - Trade Name Sq. Ft. EDR BTU Kind of Fuel Size No. HP Capacity Sq. Ft. EDR BTU HP Company . Defendable Heating and A/C Signed By�ca_py,o �fj� n nn Tel. No. 757-5040 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Laedive On January 1, 19Y3 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR ash � :'�..':.>:•; .�: ::... WasherDra'n Gas neUrinalShower .. ... Water Heater a EleStories e Basent m Floor 1 Floor 2 F oor 3 I 0 4 Flo r PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4:00 specified agreeing to do all work In strict accordance With the city codes 1� Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated In this application are true and correct. J Catch Basin _ $ 7.00 Rain Water Leader $ 7.00 AIIS '1993 Sump/Receiving'Tank $ 7.00 Water Treating Appliance $10.00 Owner a Water Heater —Electric $ 7.00 I Water Heater — Gas $10.00 Building Used As ? Gas Range $10.00 ��•�� / �] .a Gas Dryer $10.00 Estimated Cost '7UU- if v PERMIT NO. ` 13 Back Flow Preventer Required ( )Yes O No Type •$5.00 PLUMBING COMPANY. �- Reinspection Fee $30.00 SIGNED BY TEL N0.75-&��� ALL OTHERS AND/OR REPAIRS AND ALTERATIONS „n 1 % of Value of Fixture or Appliance �� 0" Approved y Rough—In Date Final Date State Surcharge $ .50 3s _ MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTk FEE $115) PLUS THE $.50 STATE SURCHARGE Building Inspections 763-572-'3604 ,91 TE I SITE ADDRESS -I141S APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE NPITH APPLICATION PROPERTY TYPE PEIRIAN TYPE BUILDING Perini No.: RESIDENTIAL APPLICATION �.t3tmei sad By: CITY OF FWDLEY l7�ate _ YOUR E-MAIL ADDRESS 13 OWNER XfC.ONTRACTOR STATE I,ILEN�SE E p S (� S�✓ EXP DAT AVDRESS: % 0 7� 1� — CITY, L O BASRMIrNT FINISH 0 DECK 1 17 MAIN? DESCIUDE WORK.'BEING DONE. SIZE OF IMPROVEMENT fiuMBIM OF SQUAILBS AGES PROFOSm SI7.E-_ FROPCISFD HEIGHT: _ SI1D11NG 13 Vinyl 13 Aluminum 17 Other _ W t3 rcx�: 0 SIDING la swum u ravvvu v+•+ O HOl15E & GARACIE CI ATTACHED GARAGE 0 DETACHED GARAGE nSot4it 0 Trim 0 Famis J CI ORAIN 77LE 0 OTHER IN 6 IST�ING OPPwas Yf% MNo LOCATION OF WINDOWS OR FOR NEW OPENINOS�=D�$SSCRISE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED ' NUMBER OF'WINDOWS AL1_ VEES ARE BASED ON VAL ATION, INCLUDING TIDE COST OF (USING THE 1997 U.B.0 FEE SCHEDULE) HEIGIi BASF ENT REM,ODJ ' SL1B 1. Existing Flo r Plan 2. Proposed fic oT plan 3. Last of struo nral m=bcn, to be used FOR NEW CONSTRU I70N INCLUDING DWKS, INS R S 1. Sim Plar6 ey showing Ole Misting A=tutes and p Project. 2. Two sots o nsttuction plans 3, Pmu0 Cat Mations , OR AND 1lIATE ALS: Permit Fee _ -- - $ See Back Page for Fee Schedule Pian keview $ r 650/0 of Building Permit Fee Fire Surcharge $ a .001 times the toted job valuation Surcharge $ a .0005 x Permit Valuation Minimum $.50 !..Xenia Surcharge $ $5,00 (Stout Licensed Residential Contractors) SAC Charge $ $1675 per SAC Unit (Plane to M'WCC for determt Curb Cut Escrow $ ft + 6 ft = _ ft x $21 $ „^ 'Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary( ) Total Due $ Make checks gaymble. to: CKy of Fridl THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL. PROCESSEV 1 hereby apply for a building permit and I acknowledge that the information above is complete and accu conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes permit but only an application for a permit and work is not to :Mart without a peimit; that the work will be In plan in the cast of all work which requires review and approval of plans. SIGNATURE OF APPLICANT Attach Ite; that the work will be in that I understand this is not a gcotdance with the approved Td i cP-O : t?0 Z00Z 7,0 ' I n f LeZT ZZS29Z : "ON XHd Fla I p T ad Jo R;10: WONJ