Permits - Permit# 8-6-82 - 2421 Black Lake Road - 1/1/1982PERMIT NO.
CITY OF SPRING PARK
P.O. Boy 452
4349 Warren Avenue
Spring Park, MN 55384
BUILDING PERMIT APPLICATION
OWNER_ 4L it IV CT,e C S i4d e e - DATE �- z
ADDRESS T„ Al T IV C TELEPHONE 7d'6- yz
BLDR--CONT_ Z)O u C— ; & ,,, rS TELEPHONE
Location of Proposed Improvement
STREET ADDRESS 0 EST. COST
PLAT_. 4,4 %o PARCEL 30 o a ZONING_ ' S '/0 6�w i iA�L
COMPLETION DATE_ SAp dl -FT w F a m it- PIN NO. / y -117 -
Application Requirements A60RoaR44-
Survey. . . V/ Energy Comp. . . . ._ Heating Layout. . . .
Plat Plan. Elevations . Sewer/Water location. .
Structural Plan"..._Watershed . . . . . —7j_' County Driveway* permit. .—
Other. .
Types of.Construction
New Construction
Single family
Sq.
ft.
Multi family
Sq.
ft.
r_Commercial
Sq.
ft.
_Industrial
Sq.
ft.
_Garage -size
Sq.
ft.
Deck --size
Sq.
ft.
Patio --size
Sq.
ft.—
Fence--size
Ln.
ft.
PERMIT FEE 3
SURCHARGE /
PLAN CHECK FEE
S.A.C.
AVAIL. CHG.
OTHER
TOTAL $ SD
Remodeling
_Addition
_Interior
Sub level
,_Roofing
Siding
Utility Bldg.
Sq.
ft.
Sq.
ft.�`
Sq.
--
ft.
Sq.
ft.—�
Sq.
ft.�`
Sq.
ft.�—
h!. 0 V% N CY 9 4,64 G E r-R 6 M J-Ck. s S
I�% e- Step Ut T
PERMIT APPROVAL
PLANNING COMMISSION a_Anroved 8-11-82
COUNCIL
OTHER PERMITS REQUIRED
/ A Sewer/Water Connection
N/� Plumbing __Excavation
V Demolition
In case permit is granted, I hereby agree to do the proposed work in accordance
with description above set forth and according to the provisions of all the
ordinances of the City of Spring Park and'of all statutes of the State of
Minnesota in such cases made and provided.
DATE