Permits - Permit# 11-9-77 - 2452 Black Lake Road - 1/1/1977CITY OF SPRING PARK Permit No.
P.O. Box 452
4349 Warren ue
ring Par
BI IN PLICATION
OWNER �-Gt i DATE 117 "7
ADDRESS QZ15 D [� J ck(Aa 1. 6 TELEPHONE 4 7 I - R(b 1n
BLDR. -CONT. 1-TELEPHONE
Location of Proposed Improvement
STREET ADDRESS c bcxe__ EST. COST
PLAT /, f(17 PARCEL ZONING
COMPLETION DATE
Application requirements
Survey v"' itnergy Comp....... Heating Layout..........
Plat Plan ....... Z Elevations ........ . Sewer -Water Location....
Structur 1 Plan.. ,/ Watershed.......... County Driveway Permit...
Other 101.0 Ia _ <
Types of Construction
NEW CONSTRUCTION REMODELING
Single Family Sq.
Multi -Family
Sq.
Commercial
Sq.
Industrial �7, Sq.
Garage -Size r Sq.
Deck -Size
Sq.
Patio -Size
Sq.
Fence -Size
In.
PERMIT FEE d
SURCHARGE
S.A.C. $
AVAIL. CHG.$
Ft.�
Ft.
Ft.
Ft.
Ft.
Ft.
Ft.
Ft.
Addition
Sq.
Ft.
Interior
Sq.
Ft.
Sub Level
Sq.
Ft.
Roofing
Sq.
Ft.
Siding
Sq.
Ft.
Utility Bldg. -Size
Plumbing
PERMIT APPROVAL
PLANNING COMMISSION
COUNCIL
Sq. Ft.
OTHER $
Total p D
In case permit is granted, I hereby agree to do the proposed
accordance with description above set forth and according to
visions of all ordinances of the City of Spring Park and of
of the State of Minnesota in such cases made and provided.
DATE APPLICANT
work in
the pro -
all statutes
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CITY OF SPRING PARK
SPRING PARK, MINNESOTA
PLAT ( F, 65
PARCEL 500-D
PERMIT #
BUILDING PERMIT CHECK -OFF LIST
NAME
W11
DATE ISSUED
Plans and specifications f/ Survey k----
Plat plan showing:
Location of proposed buildings or structures (garage)
Location of proposed alteration or addition to
existing buildings
Copy of variance ( if needed)
Setbacks - 10 feet side & back - 30 feet front
Location of water/sewer availabilities
PERMITS: Plumbing Sign
Hennepin Co. Vlfi Other
R3 Elevation of proposed building or structure & area
6L.Surface drainage plan
Impervious surface (square feet)
Soil evaluation (if necessary)
Location of off-street parking
Deficient assessments required
Assessments paid or waivers signed
Delinquent taxes paid
Fire Code - sprinkler system required
IN signed for reimbursement of any fees
encountered by City for engineering and/or legal
gone � Lot sq, ft. 22D
Hcuse sq, ft. f/,7� Garage sq. ft. Z
Othe. impervious surfaces sq. ft.