Permits - Permit# 02-041 - 2412 Black Lake Road - 1/1/2002CITY OF SPRING PARK
P. O. B6X 452
4349 WARREN AVENUE
SPRING PARK, MN 55384
952-471-9051 FAX 952-471-9160
BUILDING PERMIT APPLICATION
Building Permit Application Requirements:
1. Application to be filled out & signed
2. Mechanical Permit Application & Calculation filled out
3. Energy Calculations filled out
4. Furnish a Certificate of Survey - See Attached
5. Furnish 3 sets of Construction Plans
a)1 set for City files
b)1 set for builder to use on site
c)1 set for City Building Inspector
Construction Plans should include:
1. First floor plan
2. Footing & foundation plan
3. Elevations of all sides
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)
JOB SITE ADDRESS
Date Received
Date Approved
Permit No.
Fees To Be Charged:
Permit Sf.
State Surcharge s- o
Plan Review
SAC Charge
Availability Chrg
TOTAL -3 % -� '!�-
OWNE OR CONTRACTOR /'7` // 2 ",?.? -/-2 - GO c,/y
NAME OF OWNER 1 CI JCL & S Qkf-1 c QkrlS afl HOME PHO E 9�?-y�l-a`3Co3 WORK PHONE 61 Q-e�a—I0 I
MAILING ADDRESS ayla /IQ—LJ�L_i GQ_ i�tT4D� CITY 5 Zip -Z55N3kLI
CONTRACTOR PHONE lb 71a3&3 MOBILE PHONE
MAILING ADDRESS kL CITY ZIP 1 is
STATE LICENSE NO.
ARCHITECTIENGINEER
PHONE
MAILING ADDRESS CITY ZIP
NAME REGISTRATION NO.
TYPE OF WORK• N ADDITION
REMODELIALTERATION
_ ACCESSORY STRUCTURE MOVE DEMO
RENOVATE LAND ALTERATION
o • • ,.. _MI MA 1/
ZONING DISTRICT
STORIES SQ. FEET OR EACH FLOOR NO. OF BEDROOMS GARAGE STALLS
ATTACHED OR DETACHED BLDG. SIZE: LENGTH WIDTH HEIGHT
ESTIMATED CONSTRUCTION VALUATION (excluding land) $ lea
BUILDING PERMIT APPLICATION
PAGE 2
HARDCOVER CALCULATION WORKSHEET
A. House X =
S.F.
h Width
X =
S.F.
B. Garage X =
S.F.
C. Driveway =
S.F.
X =
S.F.
D. Sidewalk X =
S.F.
X =
S.F.
E. Patio/Deck X =
S.F.
F. Other X =
S.F.
I. TOTAL HARDCOVER
S.F.
2. TOTAL PROPERTY AREA
S.F.
1 DIVIDED BY 2 X 100 =
%
I hereby apply for a building permit and 1 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 eOAW-°/`— DATE 16 -/ 5'Oo`Z,
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
BUILDING CODE PLAN REVIEW
Name Date
HENNEPIN COUNTY, MINNESOTA
SWTH'LUIE OF 10 FOOT ALLE'
AS OPENEC THROUGH LOT 10. 'CORONADO PARk,
— —-------- — — -------------- -- —T
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SOUTH Ll* OF LOT IQ r,
CORONADO PARk.
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• •To•ta.l....$39•..2.5.. .
XD..QZ-.41 .........
ate of Minnesota, ... City.....of .....Spri.ng .Park ........
County of .... Hennepin Building Inspector
Office of ..............................
But-lbing Ilertuff
IN CONSIDERATION OF The statements and representations made by ......................
Todd Johnson
............................................................ :.......................................
in application therefor duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY
GRANTED To said Todd Johnson
.........................,..................................................as owner
Construct a fence per application .....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 ........ _....... .
B19-117-23-12-0044
...2412........lack.Lake.........Road...............................................................................
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 1.s... contractors, agents, workers and
employees, shall comply in all respects with the ordinances of the ... City 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 followin g:.None of t h e following
......................................................
(Electrical work, plumbing, heating, plastering, etc., if such there be.)
for which special permits must be secured.
Given under the hand of the Bu,i 1 d.i.n.g I.ns.peq. qo of said ....Ci.ty ........... . . and its corporate seal and
attested by its ......Clerk this .18th y October 2002
day of ...................Year........ .
Attest:
William D. Weeks
.......Gl .e.r.k............ .
............Lyl.e Oman ....1.�. Cf
/
..Building.Inspector....