Permits - Permit# 249 - 2436 Black Lake Road - 1/1/1974APPUCAUGN FOR SUOLDONG-PERPHY
VILLAGE OF SPRING PARK
SPRING PARK, MINNESOTA
Please Print. or Type
afire)
AAddress) (Tel.
PERMIT NUMBER
.
ARtAITECT (No -me)
( ddrcss) (Tel. No.)
ESTI MATED COST
BUILDER
(Address) (Tel. NO-)
PERMIT FEE TO
DATE
...................
P I LIIMBING FEE
LEGAL DESCRIPTION (Obtai no6l e from Assessor's
Office)
TOTAL
PLAT NUMBER PARC DISTRICT'$
1-3
i - c)
COMPLETION DATE
L)
PROPOSED USE-
NUMBER OF OFF-STREET
PARKING SPACES
Residential
Nonresidential
Enclosed
One family
® Amusement, recreational
Outdoors
— Two or more family Enter
— Church, other religious
number of units ------
IndustrialPar
— T r onsienthotel, motel,
or dormitory - Enter number
king Garage
SPACES REQ.
of unit
Service station, repair garage
Garage
Hospital, Institutional
SPACES ON PLAN
Carport
Of fl cc, bank, professional
Other - Specify
Publ Ic Utility
Sc . hool library, . other educational
NUMBER OF OCCUPANTS
OR SEATS
Stores, mercantile
Tanks, tc,wcrs
OCCUPANTS
Other Specify
SEATS
TYPE OF WORK
LOADING BERTHS
NEW CONSTRUCTION ALTERATIONS ADDITION FINISH ATTIC
NUMBER REQUIRED
FINISH BASEMENT PORCH. GARAGE REROOF RESIDE
—
NUMBER PROVIDED
MISC.
SIZE OF EACH
SIZE OF STR CTURE (Height) (Width, (Depth) NO. OF SjPRIES
TYPE CONSTRUCT ON
EXTERIOR FINISH ,7
TYPE OF ROOF
PRINCIPAL TYPE OF HEATING
PRINCIPAL TYPE OF FRAME
il-, Gas
TYPE OF MECHANICAL
(wall bearing)
— oil
Gr.
Will there be central air conditioning?
-Masonry
Wood frame
— Electricit y
F. A?.
Yes No
St ructural steel
Coal
Wtr.
Reinforced concrete
Other - Specify—
Stm.
;gill there be an elevator?
Other - Specify
Yes No
4 17 (COMPLETE REVERSE)
,�j
259 MILLER-OAV16 CO., MINN
ffitate of Minnesota,
County of....:. c t cam ................
......... ......of ...... �.:...
Office of ........ /-�. �_.�........ ✓- .::....................
IN CONSIDERATION OF The statements and representations made by
i/l _, l . _
in —application therefor duly_ filed in this
which
(build, erect, iII=14 add to, alter, rejuir, move, wreck, as the case may be)
ation is hereby made a part hereof, PERMISSION IS HEREBY
.. .._ _.as owner "
building described as follows: kind of construction
I
front or width in feet_ � -6- side or length in height in
number of stories.,__ _ e...._..; contents _._ ---..._.._......cubic feet; ___...._—_._._.._.._..._..._.square feet, upon that
tract of land described as follows: Lot...../ —blot C__Z!2 2 __.__..; plat or addition. e S — 6 D 6.Q
which tract is of the size and area spedfied in said application.
This permit is granted upon the express conditions that said owner and his contractors, agents, woen and employees, shall
comply in all respects with the ordinances of the........................................................of.......�.......................; that it does
not cover the uof public property, such as streets, sidewalks, llm
eys, etc., for which sp cial permiZust be secured; and that it doesuse
not cover the following:...-- ________ _ _._ _ _ _ _... ...... ..__.._ . ...�
(Electrical work, plumbing, heating, plastering, etc, if such there be.)
for which special permits must be secured.
Given under the ha d of the .... /<�........:.............of said.................. .........................and its corporate seal and
attested by its � ---..day of.
Attest: X
....... .... . ...............................