Permits - Permit# 99-09 - 2452 Black Lake Road - 1/1/1999CITY OF SPRING PARK
P. O. BOX 452
SPRING PARK, MN 55384
471-9051 FAX 471-9160
BUILDING PERMIT APPLICATION
Building Permit Application Requirements: Date Received 9 _
1. Application to be filled out & signed Date Approved
2. Mechanical Permit Application & Calculation filled out Permit No.
3. Energy Calculations filled out
4. Furnish a Certificate of Survey - See Attached
5. Furnish 3 sets of Construction Plans Fees To Be Charged:
a)"I set for City files Permit%Sd
b) 1 set for builder to use on site State Surcharge S
c) 1 set for City Building Inspector Plan Review
Construction Plans should include: SAC Charge
1. First floor plan Availability Chrg
2. Footing & foundation plan 7 ram.
3. Elevations of all sides TOTAL v -�
4. Wall sections & cross sections
5. Details - stairs & any special connections
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
THE APPLICANT IS (CIRCLE ONE) OWNER R (� CONTRACTOR
JOB SITE ADDRESS I;zLl 5 a la 1� oCLd :50n N 0a (nil
NAME OF OWNER 1 a 1 HOME PHONE Ud "4-71 r -WORKKPPHHOONEE, irl9
MAILING ADDRESS CITY ZIP , �—
CONTRACTOR PHONE MOBILE PHONE
MAILING ADDRESS CITY ZIP
STATE LICENSE NO.
ARCHITECTIENGINEER PHONE
MAILING ADDRESS CITY ZIP
NAME REGISTRATION NO.
TYPE OF WORK: NEW ADDITION ACCESSORY STRUCTURE MOVE DEMO
REMODELIALTERATION RENOVATE LAND ALTERATION
PROPOSED WORK (Describe in Detail) f? i'1CQ. Aaw t1 1Slc 0 Q C �
ZONING DISTRICT
STORIES SQ. FEET OR EACH FLOOR NO. OF BEDROOMS GARAGE STALLS.
ATTACHED OR DETACHED BLDIZE: LENGTH WIDTH HEIGHT
ESTIMATED CONSTRUCTION VALUATION (excluding land) $ ��
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BUILDING PERMIT APPLICATION
PAGE 2
HARDCOVER CALCULATION WORKSHEET
A.
House
X =
S.F.
Length Width
X =
S.F.
B.
Garage
X =
S.F.
C.
Driveway
X =
S.F.
X =
S.F.
D.
Sidewalk
X =
S.F.
X =
S.F.
E.
Patio/Deck
X =
S.F.
F.
Other
X =
S.F.
1. TOTAL HARDCOVER
S.F.
2. TOTAL PROPERTY AREA
S.F.
1 DIVIDED BY 2 X 100 =
%
I hereby apply for a building permit n wl that he information above is complete and accurate; that the work vnll be in conformance
with the ordinances and codes of the C n 't Stat Building Code; that I understand this is not a permit and ork is of to start without
a permit; and that the work will be in a n e f5 e a proved plan.
APPLICANTS SIGNATURENAA DATE
INSPECTION REQUIRED: WORK REQUIRING SEPARATE PERMITS:
Footing before a pour Plumbing
Framing rough -in Mechanical
Insulation Well
Wallboard before taping Grading & filling
FINAL before occupancy Sewer
Water
WORK BEYOND OR WITHOUT A REQUIRED
INSPECTION WILL BE SUBJECT TO PENALTY Electrical from State
24 HOUR NOTICE REQUIRED CALL 471-7357
ZONING CERTIFICATE
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.
Name Date
BUILDING CODE PLAN REVIEW
Name
Date
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SCALE IN FEET
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I hereby certify that in accordance with the provisions of Chapter 508, Min
amended, I have surveyed the following described tract of land in the Count
Minnesota, to wit: Tracts B and C, Registered Land Survey No. 1352, Files
County of Hennepin. That the survey shown hereon is a correct delineation
Dated this day of A.D. 1978.
Larry R. Couture, Lan
Minnesota Registratio
CITY OF SPRING PARK
This registered land survey was approved and accepted by the City Council o
a regular meeting thereof held this day of A.D. 1978.
Fnom Nn_ 21%q Ua 11 lat i nn $ i 1 nn nn BUSINESS RECORDS CORPORATION, MINNESOTA
Permit $37.50
State $ .55 V,.,99-09........
'Totd 1' '$38.05
ate of Minnesota, ... q l.ty...... of ... Spring Park
County of ..... Hennepin ........... Office of ..Qwilding.InspectOr...
Ltt� tit perwift
IN CONSIDERATION OF The statements and representations made by ......................
.................. Todd.A P.inger....................................................................
in application therefor duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY
GRANTED To said ....Todd ASChingel^....... . ......... . . ...... . ... . . . ....................... as owner
to .. Construct. a..fence. per. .appIication. ........................a building described as follows: kind of construction
(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; ............... square feet, upon that
tract of land described as follows: Lot ................ Block ................. ; plat or addition ................
2452 Black Lake Road 19-117-23-12-0050
....................................................................................................
which tract is of the size and area specified in said application.
This permit is granted upon the express conditions that said owner and h is. • contractors, agents, workers and
employees, shall comply in all respects with the ordinances of the .....City . . , . . , . . . . . of , ,S.pr i.r1q .Park ....... ;
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:..... None, of, the. f o 11 ow i ng. . . ......................... .
(Electrical work, plumbing, heating, plastering, etc., if such there be.)
for which special permits must be secured.
Given under the hand of the Bu i 1 d i nq Inspector .. of said C i ty. . . . . ....... . . . . . and its corporate seal and
attested by its ...... Perk............ this ... 140 ................ day of ..Agri 1 ................ 19.99.. .
Attest: /ICE I
................. Patricia..Ki.ggs, ....(� I
....... Qi�rk............
........... Lyle. Oman.... (). ( .)................ .
..... Bui.Lding .Inspector. .