Permits - Permit# 99-22 - 2413 Black Lake Road - 1/1/1999Y
JUN--06-1999 23:07 HALES f'PCHiPAF_ TOOL S125`539457 P.02.,'03
CiTY OF SPRING PARK,
P. 0. BOX 452
SPRING PARK, MN 55384
471-9051 FAX 471.916'0
BUiLDiNG PERMIT APPLICATION
Building Permit Application Requirements:
1. Application to be filled out & signed
2. Mechanical Permit Applicaatlon & C1150( laation filled out
3. Energy Caicuiations filled out
4. Furnish 9 Cer'trfcate of Survey . See Attached
S. Furnish 3 sets of Construction Plans
aj 1 set for City files
b) 1 sgt for builder to use on site
01 set for City Building Inspector
Construction Plans should Include.
1. First floor playa
2. Footing & foundation plate
I Elevaftns faf ell sides
s. Wall sections & Croaa taecdons
S. D'etalls - stairs & any special connections
ALL mIFORAMATM MUST BE SUBMITTED Iid FULL "I'cis PILAN REVIEW WILL SE STARTED
*rIE APPLICANT IS (CIRCLE ONE)
JOS SITE ADME s
OWNER OR
Date Received e'191 o y
081tV /PRroved 4111 % �
POMIt No. q
Fees To Be Charged:
Permit
State Surcharge So
Plan Review
SAC ChaMe
Avail -ability Chrg
TOTAL Jyl';;�S
/a
NAME OF OWNER - ' � �—
IaOMI; PFIOIYE --WORK PHONE � 1/
MAILING aAORRJ:ss C" _ ZIP ,.7 a
CONTRACTORPates (� yj -'73
MAILING ADDRUS 1Z:t —3`7i PHONE
CITY ZIP
STAVE LIOENOE NO, _ a �—
ARCHITECTIENGI VEER
PHONE -
MAuAIG ADOMS CITY
ZIP
NAME
REGISTRATION NO,
TYPE OF WORK: NEW_ ADDITION._ ACCESSORY STRUCTURE _ MOVE, _ DEMO
REMODELIALTERATIAN RENOVATE LAND ALTERATION_
PROPOSED VmW (Describe In Dowl) . -"�„ 'I_ i VA c.
ZONING DISTRICT 4a"- _ ��—
S70RIES — SG. FEET OR "CM FLOOR "O. OF BEDROOMS
GARAGE STALLS
ATTACHEDOR DETAWIEO DR DC, SIZE: L,ENGTI'a
— WIDTFt _ MEJGFiT
ESTIMA,TEL CON&TRU 771ON VALUATM N (eYWUUIr g ]*Rd) 9 �z ~�
v
JUN-06-1999 23:07 HALES MAt_HiNE TOOL
BUILDING PERMIT APPLICATION
PAGE z
61125539467 P.03/03
HARDCOVER CALCULATION wORKSHEET
A. House X
WWII y - �
S.F.
x. =
S.F.
I3. Off® X
_
S.F.
C. Driveway x
- ..
S.F.
X �
S.F.
D. Sidewalk X
m
S.P.
S.F.
E. Pao/bock X
--
IF.
F. other X �$
9.. TOTAL HARDCOVER
S.F.
'TOTAL PROPERTY AREA
S.F.
� CEilllfiEl9 ®Y 2 X 100
'Yo
h®tabr spWly � � bulleDaq p� ---��_
"M � ordburzag ow i OMy "•` t tlen above it complete and Rawate, the the work WIN be ki vmftrmame
A pOrAat; slid g8t ! arerk be 111 i I g1R819 m perrydL and Work
WNh ft droved Plan. I8 sW to wAn
wwwut
APPLICANTS SIGI•IATURl;
DATE ` Z
INSPECTION REQUIRED:
—Footing before o pour WORK REQUIRING SEPARATE PERMITS..
• ,frming rough-in—._.®Plurnbing
...� o..., Mechankcal
-insulation
-- _ W`idIboar9 before taping `_ Weil
-----FINAL before occupancy g � Riling
--_Grading
—_���
WORK BEYOND OR WITHOUT A REQUiRIED _Water
INSPECTION YIIiLL BE BUB.IECT TO PENALTY/
El"bical from State
24 HOUR NOTICE REQUIRED +CALL. 248.4M0
Z4 �
l do hereby cw" to the Orono Building Official Olat tht following described work has been reviewed for
compliance wft the Zoning Requlrem*nta of the City of Spring Para
and will be aPProved for construction upon
approval of the construction PIMG by the Building Official.
Name
Date
13UlLDlf�[: rrr�G
s�_ iIpl....
Name
Date
TOTAL P.03
V- IVn. 269 Al .. 1 .. J. & A n n n
BUSINESS RECORDS CORPORATION, MINNESOTA
Y U 1 U U 1.14 V 11 .I7 I V V V
Permit $ 34.75
State , , ,$, ,,50
Total $ 35.25
XD..9.9.22.........
Otate of Minnesota, ... C i t.y..... of. . Sp.r. i n g..Park .........
County of. .Hennepin Office of .Building. I9sp,gctor, ,,,,..
TO Uttbt-n rr tt
IN CONSIDERATION OF The statements and representations made by ......................
Randall Hales
....................................................................................................
in application therefor duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY
GRANTED To said ..............R d .n .d a 1.1. . H a 1 e,s . . . . . . ........................................ as owner
.....
to .... .
Re -roof building.....pe.r .d .p.p .1 .i .c d .t.i 0 ..n ... , .. 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 ................
2413 Black Lake Road 19-117-23-12-0014..............
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 i s .. contractors, agents, workers and
employees, shall comply in all respects with the ordinances of the .... C. i t y . ..... , , ... of . S,p r i n.g. 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: ... NQne..Q f, . the . f o.l, l o w i .rt g ...........................
(Electrical work, plumbing, heating, plastering, etc., if such there be.)
for which special permits must be secured.
Given under the hand of the P.O. i. l d i n,g I PAP Q C t.Q rof said .City , , , , , , , , , , , , ,,, and its corporate seal and
attested by its .. 1 e r k this .... 9 t h ................ day of . dune.................. 19..99..
Attest:
Patricia. H.l.gus....d ......... .......Lyle. Oman......�.,b.�� ................
�.
Clerk BuiAdin.g. ,195,pgcto,r ,