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Permits - Permit# 25SP-00038 - 2433 Black Lake Road - 6/18/2025.-r-I City of Spring Park I Re -Roof (Residential) PARK !Rile 4349 Warren Ave, Spring Park, MN 55384 Phone:(952) 471-9051 Fax: (952) 471-9160 For Inspections: (952) 442-7520 25SP-00038 Date Issued: 06/18/2025 Property Owner: PHILLIP ANTHONY & DEBRA LANE Expiration Date: 12/15/2025 HOLINKA Job Site Address: 2433 BLACK LAKE RD, SPRING Mailing Address: 17 OAK LANE PARK, MN 55384 Category: Residential Miscellaneous SPRINGFIELD, MN 62712 Permit Type: Re -Roof (Residential) Phone: (309) 453-2115 Valuation: $53,940.00 Email: dlholinka@gmail.com Description of Work: installing standing seam roof on house and addition Subdivision: Required Setbacks: Parcel ID: 19-117-23-12-0019 Filing: Actual Setbacks: Lot: Block: Total Sq Ft: Contractors: Fee Items Amount Primary KAUFMAN SHEET METAL & ROOFING INC State Surcharge (Fixed) $ 1.00 (612) 722-0965 Contractor License Look -up $ 5.00 Residential Building Maintenance Permit $ 50.00 Total Fees: $ 56.00 NOTICE Signature of Applicant/Date Building Department Signature/Date 06/18/2025 MUST BE POSTED ON JOB SITE INSPECTION CARD Ai City of Spring Park SPRING PARK OnLake %innetonka 4349 Warren Ave, Spring Park, MN 55384 POST THIS CARD IN A SAFE CONSPICUOUS LOCATION. PLEASE DO NOT REMOVE THIS NOTICE UNTIL ALL REQUIRED INSPECTIONS ARE MADE AND SIGNED OFF BY THE APPROPRIATE AUTHORITY AND THE BUILDING IS APPROVED FOR OCCUPANCY. STAMPED APPROVED PLANS MUST BE AVAILABLE ON THE JOBSITE. Re -Roof PERMIT NO.: 25SP-00038 PERMIT TYPE: (Residential) ISSUED DATE: 06/18/2025 EXPIRATION DATE: 12/15/2025 19-117-23- PROJECT ADDRESS: 2433 BLACK LAKE RD, SPRING PARK, MN 55384 PARCEL NO.: 12-0019 PHILLIP ANTHONY & DEBRA LANE OWNER: HOLINKA OWNER PHONE: (309) 453-2115 KAUFMAN SHEET METAL & CONTRACTOR: ROOFING INC CONTRACTOR PHONE: (612) 722-0965 APPLICANT: KAUFMAN ROOFING - MATT APPLICANT PHONE: (612) 722-0965 DESCRIPTION OF WORK: installing standing seam roof on house and addition CONSTRUCTION TYPE: OCCUPANT LOAD: DATE DATE INSPECTION INSP PASSED COMMENTS INSPECTION INSP PASSED COMMENTS Final/In-Progress 1 Fire Approval: Date: Engineering Approval: PW Approval: Date: Other To request an inspection: (952) 442-7520 Date: Date: Page 1 of 1 CITY OF SPRING PARK BUILDING PERMIT PAGE 1 4349 Warren Avenue Spring Park, MN 55384 ❑ Handout Given Routed to SAFEBuilt Phone: 952-471-9051 Fax: 952-471-9160 ❑ Lead Handout Given SITE ADDRESS: f PID: 1) Was the home constructed before 1978? (YES ❑, continue with line 2, NO IN continue without completing EPA Section) 2) Will the work disturb 2:6 sq ft of interior painted surfaces or >_20 sq ft of exterior painted surfaces? (YES ❑ go to line 4, NO ❑ line 3) 3) Are there any windows being replaced? (YES o, go to line 4, NO Wcontinue without completing EPA Section) 4) Has this home been Certified Lead Free? (YES ❑, you MUST Attach Certification Information, NO ❑ complete line 5) 5) EPA Contractor Certification Number: NAT - �� { !% ,� - ? (applies to contractor only) ' PROPERTY OWNER:.,_ r`. / H OlihHc( ,_ Address: - iaC!' Z-Q / ,t 4caie%1 � Cit :51.'; Ileti/f State:iY/i1/ Zi : s S 391 Email:�ltil7/iG! Contact Name:( PC-G b'% _ 1-101/kIl'iLl Phone: CONTRACTOR: hf/ W-/1 Address: Z If 3 CU C-r✓I�ti' /� v� S Cit : 3e,1V77 v%/ State:,liG/ Zip: ZS- v6 Phone: 6iz - '7 - U4"7'- Fax: Contractor License No: 1366 1S_g Contact Name: 11,1q7��%��/u��. EmaiLe fL ITCc Ll�Gf?61G r/ram[ , GCJ� t ARCHITECT: Address: City: State: Zip: Phone: Fax: Email: Contact Name: Phone: TYPE OF WORK: ❑ New Construction ❑ Deck ❑ Pool jrRe-Roof o Commercial iff Residential ❑ Change of Use in Retaining Wall o Porch ❑ Re -Side EST. VALUATION OF WORK ❑ Finish Basement o Demolition ❑ Fence $ ,! • 3, ! o, 00 ❑ Remodel o Fire Sprinkler ❑ Shed ' Square feet: ❑ Addition o Fire Alarm ❑ Window/Door Replacement r A G'z S 9rr ❑ Garage-Aftached/De'Mch ❑ Plumbing -provide detail on Page 2 # being replaced Detailed Description of Work: ❑ Accessory Structure ❑ MOC WICal-provide detail on Page 2 ❑ Misc Other e_4tk14 Signature of this application by the legal property owner or a licentedcontravor. at the owner's representative. 5 required and authorizes the Zoning AdminWralcr or designee and the 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 Municipality 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 within 180 days from date of permit, or if work is suspended, abandoned, or not inspected for 180 days Work beyond the scope of this permit, or work without a permit or inspection, will be subject to a penally. Noise Ordinance In Effect: MONDAY - FRIDAY Before 7 a.m. and after 10 p.m. Weekends/Holidays before 7 a.m. and after 8 p.m. SIGNATURE OF APPLICANT: ��— �� !�%% DATE: PRINTED NAME: �, r_/r,G/ This is the signature of: ❑ Owner or wner's Representative OCCUP. TYPE: CONST. TYPE: CODE: BLDG SPRINKLED Yes / No VALUATION: $ 5"3, Q `-1 l�y Permit Fee: $ �• WAC Charge: $ Plan Review Fee: $ Sewer & Water Hook -Up: $ State Surcharge: $ i • Sewer & Water Disconnect: $ Site Inspection Fee: $ Water Meter: $ S.E.0 Fee: $ Muni SE/WA Fee: $ Investigation Fee / Other Fee: $ "201 n SAC Escrow: $2,485 z Copy Charge ($.25 per 8.5 x11 page) $ _ Other: $ O License Check ($5) / Lead Check ($5) $Jr.Z�/►.� TOTAL DUE: $ Lu SUB -TOTAL t/ V Plumbing Fee (from Page 2) $ ' ynlF: Commercial plans will be submitted to the Met Council Environmental Svcs for W v Mechanical Fee from Page 2 $ SAC determination. Escrow payment will be required when permit is Issued. If after Met Council review no SAC Is determined, escrow will be refunded In full. OSpecial Conddions/Required Setbacks: Building Approval By: DATE: Printed Building App_roy,6Byit❑ License Verification ❑ Lead Verification - Checked By: City Approval By: DATE: �10 Paid: Date: I0 Receipt No. affDOC, By: P--- Jamie Hoffman From: Sent: To: Cc: Subject: payment2@thepaymentgroup.com Wednesday, June 18, 2025 12:11 PM Jamie Hoffman payment@thepaymentgroup.com MATTHEW KACHMAN Permit Payment to Spring Park, MN - Permits & Licenses from TPG Dear Spring Park, MN - Permits & Licenses, MATTHEW KACHMAN has made a web Payment through The Payment Group for: Payment Information Date Paid: Wednesday, 18 June 2025 12:11:12 CT Confirmation: Credit Card Number (last 4 digits): Credit Card Type MATTHEW KACHMAN 7CHDJC 5844 Visa 2433 BLACK LAKE KAUFMAN ROOFING ROAD SPRING PARK, MN 55384 $56.00 MATTHEW KACHMAN can be reached at: 612-363-7506 or matt@kaufmanroofing.com if there are any questions regarding this payment. Click here to login to your The Payment Group admin account Thank you once again for choosing The Payment Group! 1 RECEIPT City of Spring Park A -to", 4349 Warren Ave, Spring Park, MN 55384 (952) 471-9051 SPRING PARK 25SP-00038 I Re -Roof (Residential) On Lake %innetonka Receipt Number: 449 Payment Amount: $56.00 June 18, 2025 Transaction Method Payer Cashier Reference Number Credit Card Kaufman Roofing Jamie Hoffman 7CHDJC Comments Assessed Fee Items Fee items being paid by this payment Assessed On Fee Item Account Code Assessed Amount Paid Balance Due 06/10/25 State Surcharge (Fixed) $1.00 $1.00 $0.00 06/10/25 Contractor License Look -up $5.00 $5.00 $0.00 06/10/25 Residential Building Maintenance Permit $50.00 $50.00 $0.00 Totals: $56.00 $56.00 Previous Payments $0.00 Remaining Balance Due $0.00 Application Info Property Address Property Owner Property Owner Address Valuation 2433 BLACK LAKE RD PHILLIP ANTHONY & DEBRA 17 OAK LANE $53,940.00 SPRING PARK, MN 55384 LANE HOLINKA SPRINGFIELD, MN 62712 Description of Work installing standing seam roof on house and addition