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Permits - Permit# 270 - 2424 Black Lake Road - 1/1/1975259 MILLER-DAVIS CO.. MINN ffitatr of Minnesvita, County 1' -1 7, P_: .................... .... ....... Office of .......... ........ IN CONSIDERATION OF The statements and representations made by in..___..__...appHcation therefor duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY GRANTEDTo said_._--...____....._.._ ............. Al/_11- 7�­L e- ... . . ........... . . ..... owner t 0 - _.. - Z, L_ e_� C_'&Y. - e2 . � x-4. _. - __.. - - - - _ . ... ....... . ..... - ------ -------- building described as follows: kind of construction 'build, erect , install, add to, alter, repair, move, wreck, as the case mav be) front or width in . . . .. ............ side or length in .. .. . ....................... ; height in cumber of ....... ; contents_ --.-_.......__ _...-_,....cubJ1c feet; - - ------------ . ...... ___--square feet, upon that tract of land described as follows: Lot .... . plat or addition...( ge) C' 0-0 which tract is of the size and area specified ir. said application. This permit is granted upon the expi m-. conditions that said owner and his contractors, agents, wykrnen and employees, shall I J compiy in all respects with the ordinances of the .......... of... ...... 1, .......... L.,Z . ............... ; that it does not cover the use of public property, such as streets, sidewalks, alleys, etc., for which special p mits must be secured; and that it does not cover the following:...... . ................ ....... . . . ...... (Eecttical work, plumbing, beating, plastering, etc., if such there be.) for which special permit's must be secured., I 1� Given under the hand of the ..... ; ...............of said...................... .......... . .......................and its corporate seal and attested by its- /h22Zd19t...ay of Atte ...... .... ....................... ..................... ............... l APPLICATION FOR BUILDING PERMIT VILLAGE OF SPRING PARK It.e� fCO SPRING PARK, MINNESOTA Please Print or Type. OWNE (Name) (Address) (Tel. No.) PERMIT NUMBER a '?%a ARCHITECT (Name) (Address) ( Tel. No.) ESTI MATED COST BUILDER (Name) (Address) (Tel. No.) PERMIT FEE SaL $ DATE PLUMBING FEE 7s $ LEGAL DESCRIPTION (Obtainable from Assessor's Office) TOTAL PLAT NUMBER PARCEL NUMBER ZONING DISTRICT $ 5, 5 v y� COMPLETION DATE ©OD 9114� PROPOSED USE- NUMBER OF OFF-STREET PARKING SPACES Residential Nonresidential Enclosed Ix One family — Amusement, recreational Outdoors Two or more family - Enter — Church, other religious number of units ------ Industrial Translenthotel, motel, or dormitory - Enter number Par king Garage SPACES REQ. of units -------------— Service station, repair garage — Garage Hospital, institutional SPACES ON PLAN — Carport Offi ce, bank, professional Other - Specify Publ is Utility School , library, other educational NUMBER OF OCCUPANTS OR SEATS Stores, mercantile Tanks, towers OCCUPANTS Other - Specify SEATS TYPE OF WORK PeswQO Q( _n ���� f�-y —0O©r- f� LOADING BERTHS S'( X I� NEW CONSTRUCTION ALTERATIONS ADDITION FIN[ SH ATTIC NUMBER REQUIRED FINISH BASEMENT PORCH GARAGE - RE.ROOF RESIDE NUMBER PROVIDED MISC. SIZE OF EACH SIZE OF STRUCTURE (Height) (Width, (Depth) NO. OF STORIES TYPE OF CONSTRUCTION EXTERIOR FINISH TYPE OF ROOF PRINCIPAL TYPE OF HEATING PRINCIPAL TYPE OF FRAME Gas TYPE OF MECHANICAL Masonry (wall bearing) Oil Gr. Will there be central air conditioning? Wood frame Electr i cit y F. A. No Structural steel Coal Wtr. _yes Reinforced concrete Other - Specify $tm. Will there be an elevator? Other - Specify - Yes No (COMPLETE REVERSE) PROPERTY LINE DIMENSIONS Total square feet of floor area, all floors, based on exterior di mensi ons ..... . Total land area, sq. ft. SPOT BUILDING/s SHOWING SET BACKS STREET PROPERTY LI NE SCALE: 1/8" 1 FT. The undersigned hereby represents upon all of the penalties of law, for the purpose of inducing the Village of Spring Park to.take the action requested, that all statements herein are true and that all work herein mentioned will be done in accor- dance with the ordinances of the Village, Statutes of the State of Minnesota, and rulings of the Buildipg Inspectors. A P P R,PIVj,E D V164,AGE OF SPR NG/PARK�� � APPLICANT �_X3j l it49 v� DATE: �f 7d`— DATEa. I� !� FORM B SUPPLEMENTAL DATA FOR BUILDING- PERMIT Location of Work �y)q&cf ZG�/�� � � J�%i'���y A- . r.FNFRAI INFAFIMAZION Application Number Tax Parcel Number 1. Applicants' Name (Last, FiV-1.) 2 Day Phone 030AI/11(�-5-1172�W y11-til-13c 3. Evening PhoKo��e%l 4. General Contractor 5. Electrical Contractor 6. Plumbing Contractor 7. Earthwork Contractor 8. Architect 1. Type of Project a ] New Construction b. Addition C. Relocation d. (] Repair e. [ ] Foundation Only I. [.] Roofing 9• [ 1 Other (specify) 2 Proposed Use a. 14 Single Family b. [ ] Multiple Family c. [ ] Agricultural d. [ ] Public e. [ ] Commercial f. [ ] Industrial 9•. [ 1 Other:(specity) B. PROJECT INFORMATION 3. Lot Dimensional Data Proposed Required a. Area In ft2 or acres: b. Lot width at building line: c. Lot depth: d. Lake/Stream setback: _ e. Road setback: f. Side lot setback: g. Minimum access elevation: 4. Water Level Data In: [ ] Sea Level Datum [ ] Assumed Datum a Highest known waterlevel: _ b. Highest known ground water level: _ c. Ordinary high water level: _ 5. Structure Type [ ] Residence [ ] Ag. Bldg. ]Garage [ ] Storage [ ] Office [ ] Boathouse [ j Warehouse [ J Deck (] Other (specify below) r CTCI Ir`TIICR nATA * Calculation of Regulatory Flood Protection Elevation (RFPE) • d. Base Flood (100-yr.) Elevation: _ e. Freeboard /req'd by ordinance: _ f. Fkwdway Stage Increase: _ g. RFPE : _ (add d.,e. and f.) 6. Sewage Disposal 7. Water Supply KPubllc [Public [ ] Drainfield [ j Private Well [ ] Holding Tank [ ] Alt. System 1. Structure Elevation Requirements 2. Structure Dimensions 3. Type of Construction S. Project Cost Factors In: [ ] N.G.V.D. Wood Frame a. Cost of Improvements: $ [ ] Assumed Datum a• Length (ft.) = (O] Masonry b. Estimated Value of Existing S (] In relation to street b. Width (ft.) _ [ ] Metal Structure: C. Percentage Cost of proposed required 2 Areas in ft.- [ ] Pole Bldg. [ ] On -site Prefab Improvements : % (a. divided by b. X 100 percent) a. Basement or [ ] Off -site Prefab (lowest Floor): = c. Basement = b. First Floor d 1n Floor = 4. Heating 6. Summary of Supporting Documents (above grade): = e 2"d Floor- Oil [ ] Sketch Plan (FORM H) [ ] Lot Profile c. Max. Building U Gas [ ] Elevation View [ ] Lighting Plan Height: _ d. Fill Elev. Adjacent f. Total Area = [ ] Electric [ ] Wood [ ] Plan View [ ] Plumbing. [ ] Topo Survey (] Lot Survey to Structure: _ [ ] Solar [ ] Other (specify below): I hereby certify with my signature that all data on my application forms, plans and specifications are true and correct to the best of my knowledge: Signature of Applicant Date BUILDING PERMIT [ ] APPLICATION IS HEREBY DENIED [ ] PERMISSION IS HEREBY GRANTED TO all In accordance with the application, addendum form, plans, specifications and all other supporting date, unless specified hereinafter In the GENERAL and/or SPECIAL PROVISIONS. 1Y ORDER OF: - Signature of Permitting Authority Title Date NOTE: THIS PERMIT TERMINATES ON: except as provided for by local ordinance and/or Minnesota Law. - SEE REVERSE FOR GENERAL AND SPECIAL PROVISIONS - MDNR-MAY,1987 PAGE 2 FORM B - BUILDING PERMIT GENERAL PROVISIONS 1. This permit [ ] is ; [ ]is not subject to the State Building Code. 2. No changes in plans or specifications can be made to the work authorized herein unless such change is first approved in writing by the permitting authority. 3. Permittee shall grant access to the Site at all reasonable times so that the permitting authority or his/her agents may conduct inspections to ascertain compliance with the terms and conditions of this permit. 4. The construction site shall be kept reasonably free of debris at all times so as to not create a public nuisance. 5. Permittee shall install permanent and temporary erosion control measures in order to prevent erosion of disturbed soils from the project site onto adjacent parcels of land, public waters, public roads, ditches, sewer facilities and the like. Permittea shall cease all related authorized construction activities until such time as any such problem is corrected as agreed to by the permitting authority. 6. No certificate of occupancy or zoning compliance may be issued until all the provisions and conditions of this permit are complied with in full, 7. A copy of this permit or an official notice or placard thereof must be posted in a conspicuous place protected from the effects of weather no more than 12 feet above grade on the premises which the work is to be done and shall be maintained there until completion of said work. 8. The granting of this permit does not exempt the permittee from having to secure other permits from other state, federal or local units of government which may have jurisdiction over portions of the authorized project. SPECIAL PROVISIONS 2. 3. 4. 5. C.1 8. • ;o07�oN t � ss�zW INCoW • O*iow euluoINei S1ZC INFORMATION -NEEDED FOR GARAGES IJ • t4 E 01r H KAMP wR I 141 're• Amc,"C . O`ER HLAD DOOR boi.1 `'.o" o,C,'\ c,IZACM HIP ClABLE CrTHIiR ANY " O D + R i GAT ION FROM TH 15 5 TA N 0AR ^ OF_ -A c N CVT WTERs csi'H�R �}1oW S1L! ' - a' MgMeCRS 294 S'TUM 1(i'OL. rrre OR 8 EATI�O i`rpm of s► ►N4 4e* .,• • V120 GOhIG S iW �t 1 RE EgN � �i�`l�4�l�NOATION U' X8" M 114. PWTING, 1X1 STUM I li`D.l.. T`(PE apr JSHIC^141fiq lk-f fm cR 151c IC, K rA"' AfICHM WXT *-o fin • GON , 5 LAPS 04% (_ iw1RE MF�H It q RebARS I F?OVIM SITc P1..AN oN bkGK CW sN-IeTT TAME �6✓1 C�lSU v� y �--Wg. Age 30 X& O ADDRESS Z Z Sale Price 7S� OOU Sale Date Square Feet /Z 9 0 Bedrooms f Fireplace h &I e�, ONE ❑ TWO ❑ Central Air Conditioning YES NO ❑ Extra Baths 1/2 ❑ 3/4fa Full ❑ Finished Basement 1/4 ® 1/2 ❑ 3/4 ❑ Garage J-V(,KV0AI�ingle® Double❑ Triple® Porches/Deck Oc�,-4 l S(O Snn. Other tbw-� l eu G i 7�[�a0 "^ Lot Size