Permits - Permit# 315 - 2437 Black Lake Road - 1/1/1976APPUCATI®N FOR BU0 DNG PERNT
VILLAGE OF SPRING PARK
SPRING PARK, MINNESOTA
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OWNER (Name) (Address) (Tel. No.)
PERMIT NUMBER
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ARCHITECT (Name) (Address) ( Tel. No.)
ESTI MAT D COST
E P i me
$
BUILDER (Name)
(Address) (Tel. No.)
PERMIT FEE
DATE
PLUMBING FEE
LEGAL DESCRIPTION (Obtainable from Assessor's Office) T
TOTAL ._._
PLAT NUMBER
PARCEL NUMBER ZONING DISTRICT
$ % •' `
C% r
C: Z)0 0
COMPLETION DA
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PROPOSED USE-
NUMBER OF OFF-STREET
PARKING SPACES
Residential
Nonresidential "`
Enclosed
I
One family
— Amusement, recreational
Outdoors
I
Two or more family _ Enter — Church, other religious
number of units - - - - - -
Industrial
— Tronsienthotel, motel,
__
Par king Garage
SPACES REQ._
or dormitory -Enter
number _
of units -----------+-- Service station, repair garage
— Garage
Hospital, institutional
SPACES ON PLAN
— Carport
Offl ce, bank, professional
— Other - Specify
Publ Ic Utility
_ School , library, other educational
NUMBER OF OCCUPANTS
OR SEATS
Stores, mercantile
Tanks, towers
OCCUPANTS
_ Other - Specify _
SEATS
TYPE OF WORK
LOADING BERTHS
NEW CONSTRUCTION
ALTERATIONS ADDITION _ FI NI SH ATTIC
NUMBER REQUIRED
FINISH BASEMENT
PORCH GARAGE REROOF _ RESIDE
NUMBER PROVIDED
MISC.
SIZE OF EACH
SIZE OF STRUCTURE (Height) (Width, (Depth)
NO. OF STORIES
I
TYPE QF CONSTRUCTION
EXTERIOR/FINISH
TYPE OF ROOF
/
i
C C
PRINCIPAL TYPE OF HEATING
PRINCIPAL TYPE OF FRAME
-
TYPE OF MECHANICAL
�l Gas
Masonry (wall bearing)
Oil
Gr.
F. A.
Wil I there be central al r co itioning?
�
_� Wood frame
Electr i cit y
L/
Yes No
St ructural steel
_ Coal
Wtr.
Rel nforced concrete
— Other - Specify
Stm•
iWill there be an el tor?
Other - Specify
,..�-5''%::r/�•, �—
Yes No
i
(COMPLETE REVERSE)
1
PROPERTY LINE
DIMENSIONS
Total square feet of floor area,
all f loors, based on exterior / di mensi ons ...... \ ( lV/ ///f®
Total land area, sq. it. 75
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 Buildi ecto s.
APPROVED
VILLAGE OF SPRING PARK APP CANT
K(A -t'cJ9
DATE: DATE:
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