Permits - Permit# 580 - 2452 Black Lake Road - 1/1/1982PERMIT NO. 4 Fd
CITY OF SPRING PARK
P:O. Box 452
4349 Warren Avenue
Spring Park, MN 55384
BUILDING PERMIT APPLICATION
OWNER_ G u, G taV) S DATE 1-1042-
ADDRESS_ - 94 C <' 1. K R TELEPHONE Y%/- 2&f-gY
BLDR--CONT_ h (-f.• -TELEPF30NE
Location of proposed Improvement
STREET ADDRESS #c,e t K lP °i' EST. COST 60p
PLAT / J'-Z) 6 S PARCEL 3 o J ZONING S
COMPLETION DATE PIN NO. / 9 -/i _ z 3 -
Application Requirements
Survey. Energy Comp.. . Heating Layout. . . . .
Plat Plan. .. Elevations . Sewer/Water location. . .
Structural Plan..._ Watershed County Driveway permit.
Other.
Types of Construction
:dew Construction
Single family
Sq.
Multi family
Sq.
_Commercial
Sq.
_Industrial
Sq.
Garage -size
Sq.
Deck --size
Sq.
_Patio --size
Sq.
,Fence --size
Ln.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
ft.
Remodeling
L--"/ Addition�,(�� Sq. ft .
_Interior Sq. ft.
_Sub level Sq. ft..
Roofing. Sq. ft.-
.Siding Sq. ft.-
Utility Bldg. Sq. ft.=
PERMIT FEE PERMIT APPROVAL30
D
SURCHARGE; , ...
,.PLAN CHECK FEE PLANNING COMMIS ON
$.A.C. COUNCIL
AVAIL. CHG.
OTHER OTHER PERMITS REQUIRED N61VE,
TOTAL_ Sewer/Water Connection
p Il Plumbing Excavation
Demolition
In case permit is granted, I hereby agree to do'the proposed work in accordance
.with description above set forth and according'to the provisions of all the
ordinances of the City of Spring Park and of all statutes of the State of
Minnesota in such cases made and.provided.
DATE �` �� APPLICANT
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