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PRE 2010 DOCSCity of Fridley, Minn.. 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERNRT Date: November 17, 1971 Owner: Crown Realty Central venue N.E. Address Builder C. J. Corp. 701 Columbia Blvd. Address LOCATION OF BUILDING No. _ 1391 Street 75th N.E. Part of Lot Lot _ 5 Block 3 ,__. ___. _ Addition or Sub -Division --Don's 5th Addition Corner Lot Inside Lot x Setback 35' Sideyard ' 0'6" 616" Elevation ._S.8.4....QB....._.. __ V4YV40b4NW4VQ// 887- - CAPP-rnz),--- Wye Top of Footing To be Used as: Hous a Garage DESCRIPTION OF BUILDING Front 40' 26 Depth 25' & ?l if bight 20 Sq. Ft. 1, 020 Cu. Ft20, 200 Front 20' Depth 23' Height. 10' Sq. Ft. 460 Cu. Ft. 4,600 Type of Construction _Frame Est, 24,,_000.00 plus lgatbe Completed February 1, 1972 (18,760.00) Fill lot to drain to front and to easements Hard Surface Driveway SEWER LOCATION: 175' E. of San Sewer M.H. (Plugged) WATER LOCATION: 6" CIP 10' N.of Centerline 23' S. of property line. (Must be tapped) 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'll provisions of ordinances of the city of Fridley. " n 9.38 State Sur In consideration of the payment of a fee of It 46.00 permit is hereby granted to C .J. Corp. to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances Of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildi�$� ,,within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. E OP NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sore to a" the Building Inspector for separate permits for these hems. f APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: Crown Realty BUILDER: C.J.Corp. ADDRESS: 4219 Central Ave.NE. ADDRESS: 701 Columbia Blvd. NO:. STREET: LOT: 5 BLOCK: 3 ADDITION: Don's 5th. Add. CORNER LOT: INSIDE LOT: X SETBACK: 35 SIDEYARD;10' 6" -69611 Applicant attach to this form Two Certificates of Survey of hot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Residence 3 House Front: 40' Depth: 259,6 2 Height: Square Feet: .140 Cubic Feet: Garage Front: 20 Depth; 23 Height: /6 Square Feet; 46o Cubic Feet: �I1 Type of Construction: Frame Estimated Cost: $ 24, 000 plus lot. e To Be Completed: Feb.1,1972 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. The ,�Q.J. OR DATE: 11/15/71 SIGNATURE: B res. j (See Reverse SidLe For Addi conal Ipformation.� 9� 7'� rhe lr�_ - & J IC4 Pa � Land Amininy 687'5 H,�/i�vny •Cs NE. lurid .Strwey iI Mrnneapass)?. -501'3k3thq ENGINEERING, INC. Civil & ,Uunln�/ flblSel a 6066 fnymemy ' — Engineers Survecyors certificate of surve7 for 1/ r NIGHT H � r '6 r I � 9e- � Z3 � rr I S{orgy Fr E drKh i 1500 + i DyOYr* + -- -- y3. �- 29 7 - 77 I. -_-- D AINA rE AI',JD UTILITY E A'7,ENIF!`. i Ar/0KA 1 1' ,,1�1/ /Eby wi try Nvf A15 is a trw and mrr d represenfotwn Op 51# w y #Oh* laovntfarres ql',* aboor dx.,,bed iniad, aid fh / 9r, �+s ,11m , and d/ risible awriimenfs , many, �sn er �ta►d land As s�rntyesd rix flea SUOURBM WCWNEERiwG , INC. SALE C. 46' hy_ 1 / 01, 0 ,, !� 52-84-915.51 City of Fridley Application for Phmbbq and Gat FNI Pamb Dept. of Bldgs Phone 560-3450 DESCRIPTION Or WORE 1391 NE 75 Ave Number. Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ........... _ x $1.50 New Fixture Old Opening.......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater :Up to 99,000 BTU) . • • • x $3.00 $ New Ground Run Old Bldg. ....... . Electric Water Heater .............. GAS FITTING FEES: 1st 3 Fixtures ............... - . Additional Fixtures ................. . Gas Range to 199.000 BTU .............. REPAIRS & ALTERATIONS—Refer to Cod* x $3.25 $ x $2.00 $ NO. RATE TOTAL 1 x $2.00 $ 2.00 x$.75 $ x $5.00 $ 3.00 Description ..................... ,....................... .6 TOTAL FEE $ 5.00 (SURCHARGE $ _.50) City of Fridley: The .undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the Cita 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 9/21/72 19, Owner W. Ulsta.d Kind of Building rrame Used as Res, To be completed about 9/26/72 Estimated Cost, $ 10.00 Old =New. Building Permit No. P Signed MINNEGASCO ROUGH FINAL / oZ 3 e % r% By -- • - Business Phone No a�7 r qc 'ZR a3 rl t y�jyy IWATER • I�Qj • N MTs. 7GASELK. Base 1st 2nd 3rd 4th • Future Connection Openings e New Fixture, Old Openings Com with sowas 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 $ Water Heater :Up to 99,000 BTU) . • • • x $3.00 $ New Ground Run Old Bldg. ....... . Electric Water Heater .............. GAS FITTING FEES: 1st 3 Fixtures ............... - . Additional Fixtures ................. . Gas Range to 199.000 BTU .............. REPAIRS & ALTERATIONS—Refer to Cod* x $3.25 $ x $2.00 $ NO. RATE TOTAL 1 x $2.00 $ 2.00 x$.75 $ x $5.00 $ 3.00 Description ..................... ,....................... .6 TOTAL FEE $ 5.00 (SURCHARGE $ _.50) City of Fridley: The .undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the Cita 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 9/21/72 19, Owner W. Ulsta.d Kind of Building rrame Used as Res, To be completed about 9/26/72 Estimated Cost, $ 10.00 Old =New. Building Permit No. P Signed MINNEGASCO ROUGH FINAL / oZ 3 e % r% By -- • - Business Phone No Ci+y of Fridley ApPNition fc Piu bI'k;9 and Gas Rid ;tag 7;L3CRIPTI0rr Op WonK E)oPt. o€ BIdgo, Phone W.34U) Numb":. Kind and Location of ff ixtureu I --:? Q _ .x:-rc= w.,io ,•,W • � ,rrc -- Sewor _ Ce spool RATI E SCHIE®ULE J9,ry)o PTU) P. P,'__ : Frxtur� C:'.. `:a: to to )9'? FITU IIiFP.rR9 ? A' :iR:aT1O'tc--Refor to Codo VITAL L ('ity of Fridley: Tnc c:ndr rr;ii'nr,! hr r, t,; rn.�'r,r•s ;,Lt,Lr:,!wn !rr rm,t, t,,r t`„ x:;r `„cr:;,•d, al:r,•r•ir,;; tv rl, ,11 v.rrrlt u. t.tr)r-t ;u.c,.:;l:uur a::rl rUlct:j: of i1,•• Ir.. ru:n„•n: u° , �'-rth (t,.• I::t. l.; r,1u,,,r:c: L ,Ind .,:,u:;st:,l,•ci rn t),c•: I1au,.l-ci1 rn all tt;r• far• { N rcati„n an• a u�• :.ra c ,rr c•- t �J �.t• n, • r F-r:d of r•,J ROUGH_} TOT .� x X2!19 V -,Lo �� e x 31.50 Q --------e_ -----j �t 43.25 5� -- ---- 33.00 $ - x 43.25 — -- --- --- p3 O• MATE TOTAL - ------ :: S .75 w-- ---- . VITAL L ('ity of Fridley: Tnc c:ndr rr;ii'nr,! hr r, t,; rn.�'r,r•s ;,Lt,Lr:,!wn !rr rm,t, t,,r t`„ x:;r `„cr:;,•d, al:r,•r•ir,;; tv rl, ,11 v.rrrlt u. t.tr)r-t ;u.c,.:;l:uur a::rl rUlct:j: of i1,•• Ir.. ru:n„•n: u° , �'-rth (t,.• I::t. l.; r,1u,,,r:c: L ,Ind .,:,u:;st:,l,•ci rn t),c•: I1au,.l-ci1 rn all tt;r• far• { N rcati„n an• a u�• :.ra c ,rr c•- t �J �.t• n, • r F-r:d of r•,J ROUGH_} Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devic a PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ..........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $amu - each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,00 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTA� 1st 3 Fixtures ...................... x$ 200 $ ' Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL ' See Fee Schedule TOTAL FEE $� Dept. of Bldga. Phone SM -3450 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. Owner Kind of Building Used as To be completed about ��� r r60 Estimated Cost, $ pp O1d�Building Permit No. Permit No. .S O DESCRIPTION OF WORK HEATING or PO team, Hot Water, �-No / Trade Name- Size No Capacity Sq. Ft. E.D.R BTU H.P. v Total Connected Loa Kind of Fuel / BURNER — Trade Nam ®e Size No - Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) RAY N. WELTER HEATING C[ Signed 4637 CHICAGO AUE By MINNEAPOLIS 7. MINNESOTA 041111�042 Business Phone No- �Xs:f SUBJECT City of Fridley 27795 AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. / _ �' PROTECTIVE INSPECTION SEC. 6 ®�` (® � /--'I CITY HALL FRIDLEY 55432 NUMBER REV GATE GE OF APPROVED BY 612-571-3450 910415 9/15/987 / JOB ADDRESS 1391 75th Ave NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 3 Don's 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Iverson RAF Same 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Gates Roofing 4640 Ximines Ln Plymouth-5-50-004-1 6791 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 Q REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house & garage (20SQ) 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 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 $1,714.00 $.86 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 PROVIAJONS OF AfIY OTHER STATE OR LOCAL LAW REGULATING coN- $56.75 Fir SC $1.71 STRU ON OR THE {{{RFORMANCE OF CONSTRUCTION. �'�� PLAN CHECK FEE TOTAIAO Lice SC $5. $64.32 IGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI EN ROP YALIDAT I$ 1$ R P T BL INSP f1AT SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Contractor: �at( 1' Address: 4LQ6 K LIVING AREA: GARAGE AREA: DECK AREA: OTHER: W 561 W Tel. # MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IMPROVEMENT Effective 1/1/98 Tel. # SS0-60q) Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. ,k S Construction Type: ° ®� Td, Y� Estimated Cost: $ /91-1V (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: �' 15 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: APPLICANT: Lu Tel. # CITY USE ONLY $ �o- `%� Fee Schedule on Reverse Side $ A '% / .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1000 per SAC Unit $ S O D $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 CITY OF FRIDLEY INSPECTION DIVISION 50% --7L/1105- 6431 7y11056431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25/0 of Value of Appliance or Work Rate TOTAL $ 30.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 25.00 $ State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. .50 JOB ADDRESS_ 1.3Q1 15-hn AVB me OWN EN BUILDING USED AS Ree v ESTIMATED COST 031.00 Effective On January 1, 2002 PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) arm Air) Trade Name Size No. 6 MTI CJ BTU 70IL HP EDR Fuel ,Q Total Connected Load Burner Trade Name. ti� . Size No. BTU HP EDR 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 an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE�L-�ab- FAX # -7 L�, 3 - 75-7 -5-7 51 Approved By Rough -in Date Final Datsw-� e THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VFNT, VENT CONN TOR AND COMR1ISTION AIR V RIFI CATION When reIn acing an existing furance, the undersigned hereby verifies that the venting has been examined dThd is free from rust, deterioration, obstructions, and is securely supported and`#irestopped where required. Yes No( ) �s The venting system is plas/E/C and meets all current codes and manufacturer specifications including sizifg'angth, number of elbows and termination. Yes O No ( ) The undersigned also venfies,that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I:Central Furnace Venting Tables for fan assisted and natural draft; -appliances. Yes) No( ) The existing cnmb is oW air is sized and installed to meet the current codes and manufacturers specifications. Yes O No ( ) When required to install a new _nmb "ctinn air. it will be sized and installed to meet the current codes and manufacturer's specifications. Yes No( ) When enc aping a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Ye k) No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type 511' Building JD NOY 0 3 BUILDING Plan Review Permit No.: Inspections RESIDENTIAL APPLICATION Surcharge Received By 763-572-3604 CITY OF FRIDLEY SAC Charge Date Rec'd: /-T DATE 0I - 0(o YOUR E-MAIL ADDREW.1CC m 1 f1 ne.S0+a .- (- u 1SC U• C o r n SITE ADDRESS 9 / r 75 • 3 Z THIS APPLICANT IS: ❑ OWNER CONTRACTOR Park Fee PROPERTY OWNER/ NAME: :49A -a4 0177 ek-e $ TENANT ADDRESS: CITY —STATE—ZIP- TATEZIPPHONE: PHONE:(03 • -7s� • y(pa� CONTRACTOR Nom, A STATE LICENSE # Al %,3 EXP DATE J A/D SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 51558 kLY C= ��Y?¢',�4 - sTAT� 553` 3 WITH APPLICATION PHONE qSz • 93,5 • -7(o(e9 FAX •�SZ • 9365. gszly PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE M ADDITION ❑ GARAGEISHED ArXINDOWS 11 BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ANC&REPAIR ODELING DESCRIBEWORKBEINGDONR, n,44441 q D S n�O I Q./1 D d cl) D (1 SIZE OF IMPROVEMENT l tl1� Obl%& Oa -A` _ - PltdQt .Qa- S . Ft. ROOFING ❑ HOUSE ONfY V NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2• Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SEDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ,Yes W. LOCATION aFWINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF AA.9k r !IOM OPENING CHANGES &_ f /� p TYPE OF WINDOW TO BE INSTALLED I a 0 D ?NUMBER OF WINDOWS i� f ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB VALUATION (USING THE II.B.0 FEE SCHEDULE) TYPE Permit Fee $ '2fo -C Plan Review $ Fire Surcharge $ '7 Surcharge $ % License Surcharge $ -5-0-0 SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks savable to: Citv of Fridley Attach 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; that the work will be in accordance with the approved plan in the case of all work whic uires vi w a a roval of plans. . SIGNATURE OF APPLICANT JA -4 I. ' I PRINT NAME � I �• VU" `- DATE I I • 3 • .e 30NIVIldUVOO �yL 16 �° a I v r'yn/ I/