Permits - Permit# 04-22 - 2398 Black Lake Road - 1/1/2004CITY OF SPRING PARK
4349 WARREN AVENUE
SPRING PARK, MN 55384
952-471-9051 FAX 952-471-9160
BUILDING PERMIT APPLICATION
Building Permit Application Requirements:
Date Received Oc3 -&- d/ 41
1. Application to be filled out & signed
Date Approved
2. Mechanical Permit Application & Calculation filled out Permit No.�--
3. Energy Calculations filled out
4. Furnish a Certificate of Survey - See Attached
5. Furnish 3 sets of Construction Plans
Fees To Be Charged:
a) 1 set for City files
Permit —Af
b)1 set for builder to use on site
State Surcharge LSD
c)1 set for City Building Inspector
Plan Review
Construction Plans should include:
SAC Charge
1. First floor plan
Availability Chrg
2. Footing & foundation plan
3. Elevations of all sides
TOTAL
4. Wall sections & cross sections
5. Details - stairs & any special connections
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
THE APPLICANT IS (CIRCLE ONE)) OWNER O CONTRACTOR
G
JOB SITE ADDRESS :Z 98 /% IaLG d✓
NAME OF OWNER Gll�:000D'N 2 /Qa.Y7jp �� ,1
HOME PPHOnNE J6� -7 71- / '?WORK PHONE
MAILING ADDRESSZJ'� �612Gp� 4alli � a
CITY _fit'% � %7 ¢ ��a l � ZIP
CONTRACTOR 6�✓� �' .�' /�Q�%��C°i�� 74(
PHONE17V- -17/4/93 MOBILE PHONE
MAILING ADDRESS
STATE LICENSE NO.
ARCHITECT/ENGINEER
MAILING ADDRESS
CITY ZIP
PHONE
CITY ZIP
NAME REGISTRATION NO.
TYPE OF WORK: NEW ADDITION ACCESSORY STRUCTURE MOVE DEMO
REMODELIALTERATION RENOVATE LAND ALTERATION
PROPOSED WORK (Describe in Detail)_ &1gM ay/'h y 4511Of Sj i h 4:I e-S !I -Ad
ZONING DISTRICT
STORIES SO. FEET OR EACH FLOOR NO. OF BEDROOMS GARAGE STALLS
ATTACHED OR DETACHED BLDG. SIZE: LENGTH WIDTH HEIGHT
ESTIMATED CONSTRUCTION VALUATION (excluding land) $ __
✓
6iUILDINI_G PERMIT APPLICATION
PAGE 2
HARDCOVER CALCULATION WORKSHEET
A. House X = S.F.
Length width
X = S.F.
B. Garage X = S.F.
C. Driveway X = S.F.
X = S.F.
D. Sidewalk X = S.F.
X = S.F.
E. Patio/Deck X = S.F.
F. Other X = S.F.
1. TOTAL HARDCOVER S.F.
2. TOTAL PROPERTY AREA S.F.
1 DIVIDED BY 2 X 100 = %
1 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 and with the State Building Code; that I understand this Is not a permit and work Is not to start without
a permit; and that the work will be In accordance with the approved plan.
APPLICANT'S SIGNATURE ,/� %f DATE c1 hi L `O �dr
INSPECTION REQUIRED: WORK REQUIRING SEPARATE PERMITS:
Footing before a pour . Plumbing
Framing rough -in Mechanical
Insulation Well
Wallboard before taping Grading & filling
FINAL before occupancy Sewer
Water
WORK BEYOND OR WITHOUT A REQUIRED
INSPECTION WILL BE SUBJECT TO PENALTY Electrical from State
24 HOUR NOTICE REQUIRED CALL 249-4600
ZONING CERTIFICATE
I do hereby certify to the Orono Building Official that the following described work has been reviewed for
compliance with the Zoning Requirements of the City of Spring Park and will be approved for construction upon
approval of the construction plans by the Building Official.
Name Date
• 9_3 ► 110ATI 147
Date
....... W— -2 eo V a 1 i i;; t i n n v n n n Election Systems and Software 1-800-800-8225
Permit $38.75
State .50
'Total ..••.$39:25•
�...04722........
#fate of f itinneavta, ...... City. of ... Spring . P � r k ..........
County of.... Hennepin Office of . . .Building Inspector
But-lbing Upermit
IN CONSIDERATION OF The statements and representations made by ......................
Wi l l i aln Bartell
....................................................................................................
in application therefor duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY
GRANTED To said .... William Bartell ............ as owner
............................................
to ..... Relpo.v.e .Qld. ahin,gl.es ,and, add, new to roof , , _ ....a building described as follows: kind of construction
(build, erect, install, add to, alter, repair, move, wreck, as the case may be)
....................................................................................................
front or width in feet ................ : side or length in feet ................ ; height in feet ................ ;
number of stories ............... : contents ............... cubic feet; ............... square feet, upon that
tract of land described as follows: Lot ................ Block ................ ; plat or addition ................
2398 Black Lake Road 18-117-23-43-0015
....................................................................................................
which tract is of the size and area specified in said application.
This permit is granted upon the express conditions that said owner and h! S ... contractors, agents, workers and
employees, shall comply in all respects with the ordinances of the ....Qi.tY ............ of Spring. Park....... , , ;
that it does not cover the use of public property, such as streets, sidewalks, alleys, etc., for which special permits must
be secured; and that it does not cover the following: None o f the f o 11 owing....
(Electrical work, plumbing, heating, plastering, etc., if such there be.)
for which special permits must be secured.
City
Given under the hand of the ... Bu i 1 di n g .. In.of said ....... .
Inspector of , . . and its corporate seal and
.........
attested by its . Clerk ................. this ... llth day of June Year. 2005... .
Attest:
W.ill,ian, R.• Wee s...\, '.�� I........ ........Lyle.Oman.....<..��.�.................
Clerk Building Inspector