Permits - Permit# 9-25-90 - 2429 Black Lake Road - 1/1/1990CITY OF SPRING PARK
P. O. BOX 452 APPLICATION FOR PLUMBING
SPRING PARK, MN 55384 P E R M I T
oinera Cwtneral information
1. You may apply for plumbing permits by mail or in person at the City offices.
2. Mailed in application are subject to the postage and handling fees shown below. Permit Cards will
be sent by return mail the same day the application is received.
3. Permits are not valid until you receive a permit card.
4. Work must not begin until the permit card is posted on the job site.
5., Plumbing permits may be issued to state -licensed plumbers or to homeownsr/occupants who intend to
actually perform their own work in their home.
6.. When any new construction or remodeling is involved, a separate building permit must be obtained.
7. All work must be done in accordance with the State Building Code Requirements.
6. All work must be inspected before it is covered. Call for inspections 24 hours in advance 1
(473-7357). 1
Instructions. Complete all items on this application. Compute the permit fee. Sign and date the
certification. Incomplete applications will not be processed. If you have any questions, call.
473-7357.
WALK-IN PERMITS --Apply at City Offices. 4349 Warren Ave. I
MAIL -IN PERMITS--Raclose Pee --Mail toe P. 0. Box 452, Spring Park, MN 55384
JOB SITE ADDRESS Z4Z9 8t-, C.K LA feF PC Ap
Occupancy Type: �Residential Commercial
Work to be Performed by: Licensed Contractor _ X _ Owner/Occupant
OWNER'S NAME (�;A-P-Y t LYWU LRAdsrtN5W Telephone No. 471- q[og7'g
Mailing Address L4zA ��,�� -A RL eb SPr„05t t?AM&
PLUMBER'S COMPANY NAME Business No.
Mailing Address
Master Plumber's State License No. City Cert. No.
PLUMBING FIXTURE SCHEDULE
(Show Number of Fixtures of Each Type on Each Floor)
FIXTVRE TYPe
SSMT.
lot Floor
2 d Floor
Other Floors
FIXTURE TYP9
eSMT.
let Floor
2nd Floor
Other Floor
Water Closet
ONE
Laundry Tray
Lavatory
QNE
Washer
Bathtub
neater
Shower
ONE
Water Softner
Xltchen Sink _
Misc. Fixtures:
Disposal
<Tat)
—'—
Dishwasher__^
Wet ear
Sillrocks
Floor Drains
Sump Pump
Sewer E iectorS
PERMIT FEE CALCULATION
1.
Fixture Fee. The minimum permit.fee is $25.00.
�U0rDz)
Compute number of fixtures _ x $4/fixture
$
2.
State Surcharge
$
.50
3.
Postage and Handling (Only for Mail -in applications)
$
1.50
4.
TOTAL Permit Fee (Add lines 1-3 above)
$2
Da
The undersigned hereby applies to the City of Orono for issuance of a PLUMBING PERMIT, agrees to do all
work in strict acc dance with the ordinances of the City and the regulations of the Minnesota Brat•
8uildi C e, a d c ea atQ11tatements mode on this applic tion are completo, true andcorr ct. �p (, IL Oro %*%c+e
r yna re Aop-lidaylt Date �►'�'�
0
CITY OF SPRING PARK
BUILDING PERMIT APPLICATION 1011100111111
BIIILDING PERMIT APPLICATION I:EpUIRP.MENTS
Requirements to be handed in with Building Permit Application: Construction Plans should includes
1) Building Permit Application - to be filled out a signed e1 First floor plan
2) Mechanical Permit Application 6 Calculation filled out b) Footing a foundation plan
3) Energy Calculations - filled out c) Blevations (of all aides)
4) Furnish a Certificate of survey - if required d) Nall sections s cross sections
5) Furnish 3 sets of construction Planes e) Details -'stairs and any special connactic
a) 1 set for City to keep on file
b) 1 set for builder to use on site
c) '1 set for the City of Spring Park
I•ZONING DISTRICT
SITE ADDRESS '4« 17Lrtc.w- "�" "''` - ' "' -' -_ 00�g
es ;5L)ZVTy i9- i� -a3 a
LEGAL DESCRIPTION: PROP. ID.
— I
LOT_ %S BLOCK SUBDIVISION
FIRE ZONE
(Address) (Phone) 471-
WNER (Name) ?�-(0►3$ //5
VAR.DATE
ARCHITECT/ENGINEER - Must Certify Multi -Family, Commercial & Industrial Construction Plans
.COND. USE Dq
ERT.NO.
(Firm) (Address) (Phone) 1�—
LOT AREA
BUILDER (Firm) (Address) (Phone),419
6 3�
WIDTH
4PROPOSED
SEFRONT
TYPE OF WORK Now ddition Remodel Renovate
REAR LSIDE
CONST. TYPE BLDG. SIZE �� ('7-T1t�� EST. CONST. VALUATION
D W. Ht.
LAKE
VJCO L,
RESIDENTIAL STORIES B 1 2 .3 PERMIT FEES
..ram BLDG. PERMIT Zo? •d d
ACCESS
NEW EXISTING
DWELL. BDRMS/FLR
STATE FEE
AGENCY•APPROV. DATE
UNITS
GAR. STALLS Plannina Commission PLAN REVIEW T 3y • S�
CITY
ATT. APP. DATE
DETPENALTY
COUNTY
.
DOCK
-
NON•RESID. PROPOSED USE AVAIL. CHG.
STATE
SAC CHARGE
OCC.
CLASS. s IN 1, �
PR. EASEMENT
STORIES
COUNCIL
TOTAL DUE 3S I .SS
APP. DATE
REMARKS ND�TJ L'ONFDerrlfJ�
LOT sizes �Se7 13Ac°ks�N$n'cf� E`XfsTin/G LoT oF��c►erPn_.
INSPECTION REQUIRED
_ FOOTING before pour
_- FRAMING rough -in
INSULATION
_ WALLBOARD Before Taping
_ f'INALbefore occupancy
WORK REQUIRING
SEPARATE PERMITS
PLUMBING 454T 4 ROOM
MECHANICAL f4C
WORK BEYOND OR WITHOUT A RE- SEWER_
UUIRED INSPECTION WILL BE SUB- WATER—
JECT TO PENALTY. fJ�,
GRADING &FILLING
INSPECTION HOURS 473.7357 ce-T rZ1 C.P Lr &D-00C =
CALL 8 - 12 A.M. INSP. 1 - 4 P.M. '
CALL-1 ., _ ._..;5., _;cv.r._ne.v_,___�_,_F.LF.CIRICAL from State- _
ACKNOWLEDGEMENT
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAK
THE REAL IMPROVEMENTS SPECIFIED, AND DECLARES UND
PENALTY OF LAW ACKNOWLEDGEMENT AND ACCEPTANCE OF
ALL INFORMATION, CONDITIONS AND REQUIREMENTS REPR
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 CODE REQUIREMENTS.
Itanatu
te(pl3
ZONING CERTIFICATION
I do hereby certify to the Orono Building Official that the following d scribed 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 date
RVILDING CODE PLAN REVIEW
(�• 25 C(O
ilding Official (dato) `' .--
,Approved �_Approved with Corrections Not Approvedr Must be Revised 3 '1 •�