Permits - Permit# 11-03B - 2447 Black Lake Road - 1/1/2011fhNf,rlk
1, , 2011'
CITY OF SPRING PARK
Noise Ordinance In Effect:
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4349 Warren Avenue Spring Park, MN 55384
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Phone (952) 471-9051 Fax (952) 471-9160
Monday -Friday before 7 a.m.
;
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and after 10 p.m.
W � Z
BUILDING PERIWIT
Weekends/Holidays before 7Af
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a.m. and after 8 p.m.
DATE a3 Q
CHANGES TO APPROVED BUILDING PLANS MUST HAVE CITY APPROVAL
SITE ADDRESS ' PID
OWNER Name I r i i
CONTACT NAME -PHONE -EMAIL -FAX 00 U
ARCHITECT(if R it Name/Add r /Citv] Statene
CONTRACTOR Name i i Phn
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CONTACT NAME - PHONE - EMAIL - FAX 3-1 iL _
CONTRACTOR LICENSE #
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TYPE OF WORK
New Home
❑ Deck
❑ Re -Roof
❑ Addition
❑ Fence Height:
❑ Re -Side
❑ Commercial X Residential
EST. VALUATION OF WORK
❑ Remodel
❑ Pool
❑ Ret. Wall Height:
❑ Finish Basement
❑ Stucco Demo
❑ Window Replacement
$ o ().0
Building Height. Feet
❑ Accessory Structure
❑Stucco
o Other:
# of Stories: a
SCOPE OF WORK:
Use of Building:
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Signature or Nls application by the legal Property Owner or a Licensed contractor. as the owners representative is required and authorizes the City Zoning Administrator or designee and the City Building O1hUa! or designee
to enter upon the property to perform needed Inspections. Entry may be without prior notice. I hereby acknowledge that I have read this application and state that all information is true and correct to the best of my
knowledge. I fuller agree that all work performed will be in accordance with approved plans, specifications and cond,bons and to abide by all ordinances of me City and the laws of the State of Minnesota regarding actions
taken pursuant to Nis pe+m:l. I agree to pay all plan review fees even if t choose not to proceed wlth the work. Permll expires when work is not commenced with 180 days from date of permit iswed, or 0 bullding and
work is suspended, abandoned or not inspected for 180 days. Work beyond or without a permit or Inspection will be subject to a penalty.
Call MNSPECT for inspections at (952) 442-7520. (24 Hour Notice) 8:00 a.m. - 4:30 p.m.
SIGNATURE OF APPLICANT: DATE: I
PRINTED NAME: o aer t r DATE:
---------------------------QEFXrz LLSE ON1 Y 199LQW THIS LM ---------------------------
LEGAL DESCRIPTION: Lot Block Addition Zoning
Valuation of Permit: $ Lot Area:
OCCUP. TYPE: =L CONST. TYPE: CODE:
BLDG SPRINKLED
Yes AND
SETBACKS: REQUIRED ft ACTUAL ft
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Permit Fee•$
Front ROW
Rear .
Side°^'
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Plan Check Fee:$
State Surcharge.$
Site Insp. Fee.$ yl��' -
Side_
Corner
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(p� �rgyj��r s
C�ry `�
MunISENVA Fee.S
SEC Fee:$ /sue
Lakeshore
Wetland
/
WAC Char e $
Othe
Sewer b H2O Hook -Up•$ --, k)
Sewer & H2O Disconnect $ 5 �
Water Meter$ —
--
Paid Receipt No. -
YT}
.: 1 :-5�` < e';v. �l
Other.$
Date . By
Is
TOTAL DUE:
BUILDING APPROVAL BY: DATE: :7Z--liTIME:
AUW—'
DATE:
CITY APPROVAL BY::
TIME:
All new construction and/or dwelling expansion shall require a certified survey dated within five years of application.
,All new construction and/or dwelling expansion will be subject to contracted planner review and may add to the review time.
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