Permits - Permit# 591 - 2425 Black Lake Road - 1/1/1983CITY OF SPRING PARK
15_%/
BUILDING PERMIT APPLICATION
BUfI,U1NG PERMIT APPLICATION I:EQUIREMENTS
Requirements to be handed in with Building Permit Application:
1) Building Permit Application - to be filled out s signed
2) Mechanical Permit Application 6 Calculation filled out
3) Energy Calculations - filled out
4) Furnish a Certificate of Survey - if required
S) Furnish 3 sets of Construction Plans:
a) I set for City to keep on file
b) I set for builder to use on site
c) 1 set for the City of Spring Park
ZONING DISTRICT
a .u/'
FIRE ZONE
VAR. DATE
COND. USE DATE
LOT AREA
WIDTH DEPTH
PROPOSED SETBACKS
FRONT R.SIDE
REAR L.SIDE
LAKE
ACCESS
NEW EXISTING
AGENCY-APPROV. DATE
CITY
�.V vie i
STATE
PR. EASEMENT
REMARKS
INSPECTION REQUIRED
Construction Plans should include:
a1 First floor plan
b) Footing 6 foundation plan
c) Elevations (of all sides)
d) wall sections 6 cross sections
e) Details - stairs and any special connecti<
SITE ADDRESS
LEGAL DESCRIPTION: PROP. ID.
LOT. --La_ BLOCK _ SUBDIVISIONS
WNER (Name)
(Address) (Phone)
�ctll?[�1/�c= L - SckcJsSc �✓l
)4;�S 94,49c LAKL q0/q!D �471-y�
ARCHITECT/ENGINEER -- Must Certify Multi -Family, Commercial & Industrial Construction Plans
ERT.NO.
(Firm)
(Address) (Phone)
BUILDER (F irm)
(Address) (Phone)
55> eIle L//.sey
%��/5, n1/i� Ll - 'FZz 3 (a
TYPE (� Of WORK- New Addition Remodel enovatc
KL- /YI0V1- 0L-0 S1414IC-I- S i 3 L-4 v6�5) 441D
CONST. TYPE
BLDG. SIZE
EST. CONST. VALUATION
/f00
L. W.
IIESIDEf 1A
STORIES B 1 2
3 PERMIT FEES
�//_
BDRMS/FLR
BLDG. PERMIT O0
STATE FEE
DWELL.
UNITS
PlanningQ Commission
PLAN REVIEW 6 �S
GAR. STALLS
ATT.
APP. DA7E
DFT_
PENALTYDOCK
NON RESID.
PROPOSED USE
AVAIL. CHG.
SAC CHARGE
OCC.
CLASS.
_
STORIES
COUNCILIL
TOTAL DUE, QQ
APP. DATE
_ FOOTING before pour
_. FRAMING rough -in
INSULATION
WALLBOARD Before Taping
FINAL before occupancy
WORK BEYOND OR WITHOUT A RE-
QUIRED INSPECTION WILL BE SUB-
JECT TO PENALTY.
INSPECTION HOURS 473-7357
CALL 8 • 12 A.M. INSP. 1 .4 P.M.
CALL 1 4 P.M. INSP. NEXT DAY
ZONING CERTIFICAT.ION
WORK REQUIRING
SEPARATE PERMITS
PLUMBING —
MECHANICAL
SEWER _
WATER
GRADING & FILLING —
ELECTRICAL from State
ACKNOWLEDGEMENT
M
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE
THE REAL IMPROVEMENTS SPECIFIED, AND DECLARES UNDER
PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPTANCE OF
ALL INFORMATION, CONDITIONS AND REQUIREMENTS REPRE-
PRESENTED ON THIS DOCUMENT. THE UNDERSIGNED FUR-
THER AGREES TO DO ALL WORKS IN STRICT COMPLIANCE
WITH ALL CITY ORDINANCES AND STATE OF MINNESOTA
BUILDING CODY REQUIREMENTS.
Signatur, /7/ _7
I do hereby certify to the Orono Building Official that the following described work has been reviewed for
compliance with the Zoning Requirements of the City of SPRING PARK and will be approved for construction
upon approval of the construction plans by the Building Official.
authorized signature
BUILDING CODE Pr,AN REV
date)
'M-EM01 _ '�Z-l�--
Building Official (date)
ApproveApproved with Corrections _Not Approved; Must be Revised
Form No. 259�Rev. siom) '11,46,-ctt lS—L' 0 Ad
Miller -Davie Co.,
#ate of Isinnesaft,
County of. ... _..... _.... f..
. ............
.................X A ._� ......of ........---
Office of _..........
2!- .............
4
IN CONSIDERATION OF The statements and representations made by ..................... -... -............ .............................
.-•-...... ................................ ..
in ....... Lvv..... application therefor July filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY
GRANTED To said ................
owner
<C-f-: �� a building described as follows: kind of construction
to ....................... .fir....-.. �1 * ...._..._-----..... *-----------------...._ ._._..._._......_._......v . �__........._....._ g
(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; .......................... .7 - ..... square feet, upon that
tract of land described as follows: Lot ......... .................. _...... __..... Block ... ._.._................................. - .............. ; plat or addition..... ..... U u._...._.
_ ..._........__.... _......_..._ tract -f .............. _.........._.. ...... ..._...4�: /c'�.,- .......------ /_. .:/�_.7...- .. ....% a....II.G'.L.7...
which is othe size and area specified in said application.
This permit is granted upon the express conditions that said owner and h__4L_ contractors, agents, workers and employees, shall
comply in all respects with the ordinances of the ..................... c..................................... of ............ :; ,ov-, ......... _......... ; 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: .�'.c- a?... t 5'.......................................
(Electrical work, plumbing, heating, plastering, etc., if such there be.)
for which special permits must be secured.
Given under the hand of the......*'-��.. ..- .............of said ................ t:t _ ._ .........._........and its corporate seal and
attested by its......... �--�'.�z -----------------------_._this .__....._. �_: .