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Permits - Permit# 26SP-00004 - 2452 Black Lake Road - 1/8/2026PARK City Of Spring Park Re-Window/Exterior Door (Residential) 4349 Warren Ave, Spring Park, MN 55384 Phone:(952) 471-9051 Fax: (952) 471-9160 For Inspections: (952) 442-7520 26SP-00004 Date Issued: 01/08/2026 Property Owner: BLAKE PHILLIPS Expiration Date: 07/07/2026 Mailing Address: 2452 BLACK LAKE RD Job Site Address: 2452 BLACK LAKE RD, SPRING PARK, MN 55384 SPRING PARK, MN 55384 Category: Residential Miscellaneous Phone: (952) 221-1821 Permit Type: Re-Window/Exterior Door (Residential) Email: Valuation: Description of Work: Replace 2 windows (same size no structure change) Subdivision: Required Setbacks: Parcel ID: 19-117-23-12-0050 Filing: Actual Setbacks: Lot: Block: Total Sq Ft: Contractors: Fee Items Amount Primary Home Depot USA (847) 671-4606 State Surcharge (Fixed) $ 1.00 Building Home Depot USA (847) 671-4606 Residential Building Maintenance Permit $ 50.00 Total Fees: $ 51.00 NOTICE Signature of Applicant/Date Building Department Signature/Date 01/08/2026 MUST BE POSTED ON JOB SITE INSPECTION CARD *i=" City of Spring Park SPRING PARK OnGake911innetonkq 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-Window/Exterior PERMIT NO.: 26SP-00004 PERMIT TYPE: Door (Residential) ISSUED DATE: 01/08/2026 EXPIRATION DATE: 07/07/2026 19-117-23- PROJECT ADDRESS: 2452 BLACK LAKE RD, SPRING PARK, MN 55384 PARCEL NO.: 12-0050 OWNER: BLAKE PHILLIPS OWNER PHONE: (952) 221-1821 CONTRACTOR: Home Depot USA CONTRACTOR PHONE: (847) 671-4606 APPLICANT: HOME DEPOT USA - Scott Doughman APPLICANT PHONE: (860) 952-4112 DESCRIPTION OF WORK: Replace 2 windows (same size no structure change) CONSTRUCTION TYPE: OCCUPANT LOAD: DATE DATE INSPECTION INSP PASSED COMMENTS INSPECTION INSP PASSED Final/In-Progress Fire Approval: PW Approval: To request an inspection: (952) 442-7520 Date: Date: Engineering Approval: Other( Date: Date: COMMENTS Page 1 of 1 CITY OF SPRING PARK BUILDING PERMIT 4349 Warren Avenue PAGE 1�� L Spring Park, MN 55384 ❑Handout Given Routed to SAFEbuilt Phone: 952-471-9051 Fax: 952-471-9160 ❑ Lead Handout Given SITE ADDRESS: L40L biaCK LaKe moaa, Jpring t�arK IVIIN PID: 1) Was the home constructed before 1978? (YES 0, continue with line 2, NO ❑ continue without completing EPA Section) 2) Will the work disturb >_6 sq ft of interior painted surfaces or >_20 sq ft of exterior painted surfaces? (YES ❑ go to line 4, NODline 3) 3) Are there any windows being replaced? (YES 0, go to line 4, NO❑continue 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 - 31266-4 PROPERTY OWNER: Blake Phillips Address: 2452 Black Lake Rd city: Sprinq Park State: MN zip: 55384 Email: Contact Name: Phone: 952-221-1821 CONTRACTOR: Home Depot USA, Inc Address: 2455 Paces Ferry Rd city: Atlanta State: GA zip: 30339 Phone: 860-952-4112 Fax: Contractor License No: BC147263 Contact Name: Scott Doughma Phone: 860-952-4112 Email: permits@gopermits.org ARCHITECT: Address: City: State: MN zip. Phone: Fax: Email: Contact Name: Phone: TYPE OF WORK: ❑New Construction ❑Deck ❑Re -Roof ❑Commercial (]Residential ❑Change of Use ❑Pool ❑Re -Side EST. VALUATION OF WORK ❑Finish Basement ❑Retaining Wall ❑Fence $ 7315. ❑Remodel ❑Porch []Shed sq ft Square feet: ❑Addition ❑Demolition OWindow/Door Replacement []Garage-Attached/Detach []Plumbing -provide detail on Page 2 # being replaced Detailed Description of Work: I OAccessory Structure ❑Mechanical-; ror.de detail on Page 2 ❑Misc Other Remove and replace 2 windows same size no structural change Signature of this application by the legal property owner or a licensed contractor, as the owners representative, is required and authorizes the Zoning Administrator or designee and the Building Official or designee to enter upon the properly to perform needed inspections Entry may be without prior notice I hereby acknowledge that I have read this application and state 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 Mumcipality and the laws of the Slate of Minnesota regarding actions taken pursuant to this pennit 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 subTect to a penalty SIGNATURE OF APPLICANT: Gil DATE: 1 /5/25 PRINTED NAME: Scott DOughman VThis is the signature of: []Owner or pOwner's Representative OCCUP. TYPE: CONST. TYPE: CODE: BLDG SPRINKLED Yes / No VALUATION: $ Permit Fee: $ Park Dedication: $ Plan Review Fee: $ SAC Charge: $ State Surcharge: $ WAC Charge: $ Site Inspection Fee: $ Sewer Hook -Up: $ S.E.C. Fee: $ Water Hook -Up: $ Investigation Fee / Other Fee: $ Sewer Trunk: $ Copy Charge ($.25 per 8.5x11 page) $ Water Trunk: $ p License Check ($5) / Lead Check ($5) $ SUB $ Oro Water Meter $ City Fee: $ N -TOTAL 0 Plumbing Fee (from Page 2) $ Other: $ v Mechanical Fee (from Page 2) $ TOTAL DUE: LL Special Conditions/Required Setbacks: O Building Approval By: DATE: Printed Building App ByA ❑ License Verification ❑ Lead Verification- Che ked By: City Approval By: DATE: Paid: 1 , %"� Date: 19 1 G Receipt No. By: CITY OF SPRING PARK ❑ MECHANICAL PERMIT ❑ PLUMBING PERMIT _ PAGE 2 FOR PERMIT ISSUANCE PAGE 1 and PAGE 2 should be complete MECHANICAL INFORMATION Mechanical Contractor: Address: City State: Zip: Phone Fax: State Bond No: Contact Name Email: lContact Phone Detailed Description of Work: Indicate type of project, fixtures, and Gas Lines you will be installing or replacing (include count for each type of fixture): MECHANICAL FIXTURES GAS LINES Quantity Quantity Quantity Furnace Kitchen Fan Furnace Air Conditioning System Bath Fan Fireplace Air Exchanger Grill Unit Heater Fireplace Water Heater Unit Heater Grill In Floor Heat Dryer Gas Log_ Stove Office Use Only: ❑ Replacement (one fixture only, no piping or vent changes) Mechanical Permit Fee: $ ❑ Addition/Remodel Gas Line Permit Fee: $ ❑ New Construction State Surcharge: $ 1.00 ❑ Other Other: $ Total Mechanical Permit: $ PLUMBING INFORMATION Plumbing Contractor: Address: City: State: Zip: Phone: Fax: Plumbers License No: State Bond No Contact Name: Contact Phone: Email: Detailed Description of Work: Indicate type of project and fixtures you will be installing or replacing (include count for each type of fixture). PLUMBING FIXTURES Quantity Quantity Quantity Water Heater Shower Laundry Tub []Gas ❑Electric Dishwasher Rough -In Future Fixture Water Softener Clothes Washer Sump Lawn Sprinkler System Ice Maker Line Water Piping System Water Closet (Toilet) Hose Bib Floor Drain Lavatory (Wash Basin) Bathtub Office Use Only: []Replacement (one fixture only, no piping or vent changes) Plumbing Permit Fee: $ ❑Addition/Remodel State Surcharge $ 1.00 ❑New Construction Other: $ ❑Other Total Plumbing Permit: $ Jamie Hoffman From: payment=thepaymentgroup.com@mg.thepaymentgroup.com on behalf of payment@thepaymentgroup.com Sent: Thursday, January 8, 2026 12:19 PM To: Jamie Hoffman Cc: payment@thepaymentgroup.com Subject: SCOTT DOUGHMAN Permit Payment to Spring Park, MN - Permits & Licenses from TPG ATTENTION: if you need assistance with this payment, please FORWARD this email to tRg_ELL�tsupport@nuvei.com and include your request. Your client manager will respond. Dear Spring Park, MN - Permits & Licenses, SCOTT DOUGHMAN has made a web Payment through The Payment Group for: Payment Information Date Paid: Thursday, 08 January 2026 12:18:36 CT Confirmation: YK371X Credit Card Number (last 4 7984 digits): Credit Card Type: Visa Full Address Permit or First Name Last Name Business City, State & License Amount Payment Name Zi� Number mount 2452 BLACK SCOTT DOUGHMAN GO PERMITS LAKE RD, 2452 $51.00 LLC SPRING PARK, BLACKLAKE RD MN 55384 SCOTT DOUGHMAN can be reached at: 860-952-4112 or permits@gopermits.org if there are any questions regarding this payment. Click here to login to your The Payment Group admin account Thankyou once again for choosing The Payment Group! 1 RECEIPT City of Spring Park 4349 Warren Ave, Spring Park, MN 55384 (952) 471-9051 26SP-00004 I Re-Window/Exterior Door (Residential) Payment Amount: $51.00 Transaction Method Payer Credit Card Home Depot USA Comments Assessed Fee Items Fee items being paid by this payment SPRING PARK On Lake Yinnetonka Receipt Number: 516 January 8, 2026 Cashier Reference Number Jamie Hoffman YK371X Assessed Fee Item Account Code Assessed Amount Paid Balance Due On 01/08/26 State Surcharge (Fixed) $1.00 $1.00 $0.00 01/08/26 Residential Building Maintenance Permit Application Info Property Address Property Owner 2452 BLACK LAKE RD BLAKE PHILLIPS SPRING PARK, MN 55384 Description of Work Replace 2 windows (same size no structure change) $50.00 $50.00 $0.00 Totals: $51.00 $51.00 Previous Payments $0.00 Remaining Balance Due $0.00 Property Owner Address Valuation 2452 BLACK LAKE RD SPRING PARK, MN 55384