Permits - Permit# 00-03 - 2412 Black Lake Road - 1/1/2000Account No.
APPLICATION FOR
For Connectio To:
Water
Sewer
PERMIT
Permit No. -O,3
Village of
Spring Park,
PERMIT FEES
Water �-� 00
Sewer
Minnesota
Meter Deposit
Total J/G6
Property Owner
Contractor
Name
Address .;.y 161, 61g(-k 4
le. Q
Name LcvMc-e
Co
Address _46 5og 9 6-%v re 1+�-+en cr,r
Telephone
Telephone 612 - 5/
76k-a 31 (a -74V
Permit No.
Expires:
To Be filled out for Both Sewer or Water
Legal Description of Property Plot
Lot
Parcel
Block Add.
Has Assessment been levied?
Yes No
No. of Building or unit to be serve.
Water
Sewer
Type of Building: Res.
Comm'I. Indus.
Other
Are Water and Sewer to be installed in same ��tr//��nch? Yes
Is there Basement Under Bldg? Yes _ No
No
Full
Partial
Water Sewer
Use of Water. General Special Are all buildings properly vented
Approx. Mo. per year to be used l Service Pipe: V. Clay Cast Iron
Size of Service Required: Size— Length P'
Point of Entry to Bldg. niQAZffZ&T Point of Entry to Bldg. T- n Z-
Meter Location Necl f IgM, Kind of Joint Used L (4 jf
Is Pretreatment Required? Yes No
The Undersigned hereby agrees:
To notify the Inspector when work is ready for
inspection, and not cover any work until such
inspection is made and the work approved.
C,
Contractor. I �i`"•"
j
AFFIDAVIT
By signing this application, I do hereby declare that
all Statements herein contained, are true and correct.
That all work for which this application is made .will
be performed in accordance with applicable Ordinance
of the Village of Spring Park, the State of Minnesota,
and the rulings of the Public Utilities Department.
If at the time this application is made, the Special
Assessments have not been levied, I do further con-
sent to the spreading of the pro-rata assessment
against the described property.
Date
Owner
APPROVED BY 1
Remarks:
J O 6) v
FORM SW 1
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I FEE OWNER
.6pring Park. AN
APPLICATION FOR SPECIAL USE PERMIT
F E E S 20 -0.t2.._
PLAT . PARCEL
e
ADDRESS TELEPHONE
I LOCATION OF THE PROPERTY
I LEGAL DESCRIPTION
I ZONING
I SPECIAL USE PERMIT (use)
Signature of Applicant
Address
Applicant's Interest in Property
Tel. No.
State why this use, if granted, would not be contrary to the general purpose and
intent of the ordinance to secure public health, safety, general welfare, and sub-
stantial justice.
4p63��'1G pQL31i3
Oil LAk2 /1/i%mepomta
Mayor
Jerome P. Rockvam
471-9515
Councilmembers
Wm. D.Weeks
471-7285
MaryAnn Thurk
471-9286
Richard Dietz
471-7799
Bruce Williamson
471-1029
FAX COVER SHEET
NUMBER OF PAGES (Including cover sheet)
DATE a 6
TO
COMPANY
FAX NUMBER 5S3 - qc/ 7
FROM <�
COMMENTS
If you do not receive all the pages or have any questions, please
call. The City phone number is 471-9051. The fax number is
471-9055.
ctyof opnhyPArk
P.O. BOX 452, SPRING PARK, MINNESOTA 55384-0452 • Phone: 471-9051 • Fax:471-9055
CITY OF SPRING PARK
SURVEY REQUIREMENTS FOR CONSTRUCTION
1. All surveys shall be certified by a Minnesota Registered Land Surveyor. Civil engineers may certify
topographic surveys.
2. A certified land survey shall indicate that permanent iron monuments are in place at each lot corner.
3. Offset stakes shall also be placed on each side lot line indicating front and rear building lines.
4. Indicate all proposed buildings with dimensions of each building and reference dimensions measured
perpendicular from the front, side and rear lot lines to the nearest point of each building.
5. Indicate the locations of all existing and proposed decks, porches, driveways, curb cuts, and other
accessory structures.
6. Indicate elevations to sea level datum of the top of curb or, if no curb, the edge of the paverent
of the street at points where the side lot lines of the property intersect said street.
7. Indicate proposed elevations to sea level datun of the top of foundation, garage floor and the
lowest most floor.
8. Indicate proposed elevations to sea level datun of proposed and existing grade at each corner of
the proposed buildings.
9. Indicate existing and proposed elevations to sea level datun of grade at -each property corner.
10. Indicate location and elevation of any structures on adjacent properties within 30' of lot lines.
For lakeshore lots, the principal structure on each adjacent lakeshore lot must be shown.
11. Indicate all existing easements, drainageways and wetlands with the property and within 30' of the
property.
12. Indicate with arrows the direction of proposed surface drainage in accordance with the subdivision
grading plan (if applicable) as approved by the City Engineer. Contact City staff to determine
whether topographic surveys are required. (A hardcover survey and calculations normally will be
required for all zones).
13. For property adjacent to lakes, ponds, streams or wetlands, indicate. the established high water
elevation as approved by the City Engineer. The lowest floor elevation shall be no less than
three (3) feet above the OHW. Lowest floor adjacent to Lake Minnetonka shall be no less than
932.5 feet.