Permits - Permit# 10-31B - 4290 Shoreline Drive - 9/20/2010CITY OF SPRING PARK
4349 Warren Avenue Spring Park, MN 55384
Phone (952) 471-9051 Fax (952) 471-9160
BUILDING PERMIT
Noise Ordinance In Effect:
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Monday - Friday before 7 a.m.
and after 10 p.m.
Weekends/Holidays before 7
a.m. and after 8 p.m.
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CHANGES TO APPROVED BUILDING PLANS MUST HAVE CITY APPROVAL
SITE ADDRESS 0 Ord 11/V6 bk , PID
OWNER Name / Address / City / State / Zi
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CONTACT NAME - PHONE - EMAIL - FAX
ARCHITECT If Re uired Name / Ad ress / Ci / State / Zi / Phone
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CONTRACTOR Name / Address / City/ State / Zi / Phone
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CONTACT NAME -PHONE -EMAIL- FAX 6A/1- (Z—D 6bS
CONTRACTOR LICENSE # d OO ' 7, oP 2
TYPE OF WORK
❑ New Home
❑ Deck
❑ Re -Roof
Commercial ❑ Residential
❑ Addition
❑ Fence Height:
❑ Re -Side
EST. VALUATION OF WORK
Remodel
❑ Pool
❑ Ret. Wall Height:
$ 's-00, _
❑ Finish Basement
❑ Stucco Demo
❑ Window Replacement
Building Height: Feet
❑ Accessory Structure
❑ Stucco
Other:
# of Stories:
SCOPE OF WORK:
Use of Building:
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Signature of this application by the legal property owner or a licensed contractor, as the owners representative is required and authorizes the City Zoning Administrator or designee and the City Building Official or designee
to enter upon the property to perform needed inspections. Entry may be without prior notice. I hereby acknowledge that I have read this application and stale that all information is true and correct to the best of my
knowledge. I further agree that all work performed will be in accordance with approved plans, specifications and conditions and to abide by all ordinances of the City and the laws of the Slate of Minnesota regarding actions
taken pursuant to this permit. I agree to pay all plan review fees even if I choose not to proceed with the work. Permit expires when work is not commenced with 180 days from date of permit issued, or if building and
work is suspended, abandoned or not inspected for 180 days. Work beyond or without a permit or inspection will be subject to a penalty,
Call MNSPECT for inspections at (952) 442-7520. (24 Hour Notice) 8:00 a.m. - 4:30 p.m.
SIGNATURE OF APPLICANT:
DATE: - c;!O
PRINTED NAME. 6A/L- D: SCE Ui—IF-
DATE:
--------------------------- OFFICE USE QNL Y BELOW THIS LINE --------------_
LEGAL DESCRIPTION: Lot Block Addition Zoning
Valuation of Permit: $ "ot
Area:
OCCUP. TYPE: S - 1 CONST. TYPE: y CODE:.18
C BLDG SPRINKLE
es No
SETBACKS: REQUIRED (ft)
ACTUAL (ft)
Permit Fee:$ ,
NOTE. The applicant is Plan Check Fee:$
required to submit commercial State Surcharge:$
plans to Met Council Site Insp. Fee:$
Environmental Services for SE/WA Fee:$
Sewer Availability Charge S.E.0 Fee:$
(SAC) determination. Contact —
SAC Charge:$
Jessica Nye @ 651-602-1378 --
for submittal requirements. WAC Charge:$
Permit will not be issued until Sewer B H2O Hook -Up:$
a determination letter is Sewer & H2O Disconnect:$
provided. Water Meter:$
_other:$
TOTAL DUE: I$
Front (ROW)
Rear
Side
Side
Corner
Lakeshore
---
Wetland
_
Other
-
Paid
eceipt o `
Date
By
BUILDING APPROVAL B
DATE: ZQZi /0
TIME:
CITYAPPROVAL BY:
DATE:
TIME:
All new construction and/or dwelling expansion shall require a certified survey dated within five years of application.
All new construction and/or dwelling expansion will be subject to contracted planner review and may add to the review time.