Permits - Permit# 11-26B - 2418 Black Lake Road - 1/1/2011CITY OF SPRING PARK
4349 Warren Avenue Spring Park, MN 55384
Phone (952) 471-9051 Fax (952) 471-9160
BUILDING PERMIT
Noise Ordinance In Effect:
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M
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Monday - Friday before 7 a.m.
and after 10 p.m.
Weekends/Holidays before 7
a.m. and after 8 p.m.
DATE 8 -- — 'I
CHANGES TO APPROVED BUILDING PLANS MUST HAVE CITY APPROVAL
SITE ADDRESS Z L4 l g b' IC�_QkL PID
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CONTACT NAME. PHONE- EMAIL. FAX %L er)-vt' t9s 2- Z171
ARCHITECT (if Recuiredl Name/ Address I City/State /Zip/ Phone
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CONTACT NAME - PHONE - EMAIL -
FAX
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CONTRACTOR LICENSE #
TYPE OF WORK _ _
o Commercial IrResidential
❑ New Home
o Deck
o Re -Roof
o Addition
o Fence Hei ht:
Re -Side
EST. VALUATION OF WORK_
$ --!; eebi 6b
o Remodel
❑ Pool
❑ Ret. Wall Height:
o Finish Basement
❑ Stucco Demo
o Window Replacement
Building Height: Feet
o Accessory Structure
o Stucco
o Other:
# of Stories:
SCOPE OF WORK:
Use of Building:
'pt
signature of thb appicadon by the wool property owner or a licensed contractor. as the ow ws representative is repum and eudrorlses this City Zoning Administrator or designee and th City oulmng 5mcial Of designee
to enter upon pre property to perform needed inspections. Entry may be without prior notice. I hereby acknowledge that I have read Oft application and stale Nat all lifamaoon is We and correct to the best of my
knowledge. I fuller agree that all wok performed will be In accordance with approved pions, specifications and conditions and to abide by as ordinances of the City and the taws of Ore state of Minnesota regarding actions
taken pursuant to this permit. I agree to pay ail plan review fees even M 1 them not to proceed with the work Permit expires when work Is not commenced with 180 days from data of permit issued. or if building and
work is suspended. abandoned or not suspected for 190 days. Wok beyond or without a permit or Inspection will be Subject to a pernatty.
Call MNSPECT for Inspections at (952) 442-7520. (24 Hour Notice) 8:00 a.m. - 4:30 p.m.
SIGNATURE OF APPLICANT: DATE
PRINTED NAME: li6(f I DATE: — I
-
LEGAL DESCRIPTION: Lot Block Addition Zoning
Valuation of Permit: $
I Lot Area:
OCCUP. TYPE: CONST. TYPE: CODE: BLDG SPRINKLED
Yes I No
SETBACKS: REOU►RED (ft)
Front ROW
-- - -- �---�
Rear
Side
_ _—Side
_ Comer
Lakeshore
- - Wetland
Other
ACTUAL (ftL __
_ _
�-
'NOTE Comrnerwat plants will
be submited to the Met
Council Envr onrnental Svcs
for SAC (sewer availability
charge determination
Escrow payment will be
required when permit is
Issued If aflet Met Council
review no SAC is determined,
escrow will tie refunded in fur
Permit Fee:$_
Plan Check Fee:$
--- ---
Slate Surcharge:$ _ 0
Site Insp. Fee:$
Muni SE/WA Fee:$
S.E.0 Fee:$
'2011 SAC Eecmw $2,230
- -- WAC Charge:$ — — --
— -
Sewer H2O Hook-up:$
sewer a H2O Disconnect:$ - --
_ _-
Water Meter:$ --
aher:$
$ - � �-a' 5D
-- - - —
Paid
Date
- --- — -
Receipt No.
I By
TOTAL DUE:
BUILDING APPROVAL BY:.
— — -- -I
CITY APPROVAL BY:
I DATE.
TIME:
'DATE:
TIME:
All new construction and/or dwelling expansion shall require a certified survey dated within five years of application. -
All new construction and/or dwelling expansion will be subject to contracted planner review and may add to the review time.
R-
Permit #: 11-26B
City of Spring Park
4349 Warren Avenue, Spring Park, MN 55384
Building Permit
PINS: 19-117-23-12-0006
ADDRESS: 2418 Black Lake Road, Spring Park, MN 55384
Permission is hereby granted to: Classic Builders Remodelers, 2418 Black Lake Road, Spring
Park, IVIN 55384 — re -side.
To install or construct the improvements applied for. This permit is granted upon the condition that
the person to whom it is granted, and his agents, employees and workmen, shall conform in all
respects to the Ordinances of the City of Spring Park and to the Statutes of the State of Minnesota in
such cases made and provided; this permit may be revoked at any time upon violation of any of the
provisions of said Ordinances, Statutes, or for any misrepresentation in the application.
Approved by MNSPECT, CBO Date:
NOTE: This card must be placed in a conspicuous place at the address which work is to be
performed.
CITY OF SPRING PARK
4349 Warren Avenue, Spring Park, MN 55384
INSPECTION RECORD
PINS: 19-117-23-12-0006
ADDRESS: 2418 Black Lake Road, Spring Park, iVIN 55384
Building Inspections — Permit No. 11-26B
Footings
Framing
Insulation
Wallboard B-4 taping
Final
Others
Plumbing Inspections — Permit#
Date Inspector
Rough -in
Air Test
Final
Permit #
Date
Inspector
Sewer
Water
Electric
Note: Contractor is responsible to call for these inspections. This card must be placed in
a conspicuous place, on the premises on which work is to be performed. 952-442-7520.
CLASSIC BUILDERS REMODELERS 15468
DL G-655-261-302-394
2418 BLACK LAKE RD PH 952-471-9444 17-1/910934
SPRING PARK, MN 55384-9737 1751001809
Date
Pay to the
Order nfC--�L
oa.n. o
Wells Fargo 4 NA
MI.-
Wellsfarg" m
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