Permits - Permit# 274 - 2468 Black Lake Road - 1/1/1975APPLICATION FOR BUILDING PERMIT
VILLAGE OF SPRING PARK
SPRING PARK, MINNESOTA
Please Print or Type Be/
OWNER (Name)
(Address) // (Tel. No.)
PERMIT NUMBER
ARCHITECT (Name)
(Address) ( Tel. No.)
ESTI MATED COST c-
�±
$) v C v ---
BUILDER (Nome)
(Address) (Tel. No.)
PERMIT FEE
$ �L ". i 50
DATE / 7PLUMBING
FEE ate;
` ,(/
LEGAL DESCRIPTION (Obtainable from Assessor's
Office)
TOTAL
PLAT NUMBER
PARCEL NUMBER ZONING DISTRICT
$ G . -•�
COMPLETION GATE
PROPOSED USE—
NUMBER OF OFF—STREET
PARKING SPACES
Residential
��Nonresidential "' -Enclosed
— One family
__ Amusement, recreational Outdoors
_ Two or more family — Enter
_ Church, other religious
number of units — — — — — —
Industrial
— Tronsienthotel, motel,
Par king Garage SPACES REO•___
---
or dormitory — Enter number
--
of units — — — — — — — — — —
Service station, repair garage
— Garage
Hospital, institutional SPACES ON PLAN
— Carport
Offi ce, bank, professional
_ Other — Specify
Publ is Utility
_ School , library, other educational NUMBER OF OCCUPANTS
OR SEATS
Stores, mercantile
Tanks, towers OCCUPANTS
—
Other — Specify
SEATS
n
TYPE OF WORK
1 h S r CYO
'
C' e r I /1 c�, t' �.. �� I G1. �. _,t l/
LOADING BERTHS
NEW CONSTRUCTION ALTERATIONS ADDITION _ FI NI SH ATTIC
NUMBER REQUIRED
FINISH BASEMENT PORCH
GARAGE REROOF -_ X RESIDE
NUMBER PROVIDED
MISC.
SIZE OF EACH
SIZE OF STRUCTURE (Height)
(Width, (Depth) I NO. OF STORIES
TYPE OF CONSTRUCTION
EXTERIOR FINISH
TYPE OF ROOF
I
PRINCIPAL TYPE OF HEATING
PRINCIPAL TYPE OF FRAME
— Gas
TYPE OF MECHANICAL
Masonry (wall bearing)
— Oil
Gr.
Nil I there be central air conditioning?
Wood frame
Electr i cit y
F. A.
No
St ructural steel
Coal
—
Wtr'
_Yes
Reinforced concrete
— Other — Specify
—
Stm.
Will there be an elevator?
Other — Specify
— Yes No
(COMPLETE REVERSE)
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259
MILLER-DA"S Co.. MINNEA
... . .. .. ........................
..... .... of .......... X ........ .......... ....
--4tatr of Minnesota,
Countyof......I... .... c :I!:. ................ Office o f ........... - ........ ....... . . ............................
U 1 111 C r M ir t
IN CONSIDERATION OF The statements and representations made by_.—
. . ...........
in___.............application therefor duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY
GRANTED To . . ................ . Z: .............r ...._ ----.`......-__......______as owner
.4
to
................_..........-..-......a building described as follows: kind of construction
"build. erect, install, add ab,'alter, repair, move, wreck, as the. case moy be)
. . . . ............. . . . ...
fror.r or -;,,;dth in feet____._._.. —..._-..._ ............ side or length in feet---.------..--....-_--._--.--------------_---; height in feet__.-.__......__
number of stones___.._.,__.._.-_.—...._....; contents____. -.._.._-....._......-__ .................cubic feet; --_ ..------.--_-_-----.--_..._._-_.square feet, upon that
tract of land described as follows: Lot-.....___ plat or addition__.(.-'�
which tract is of the size and area specified in ;.aid application.
This permit is granted upon the express conditions tha(said owner and his contractors agents, w /9�kmeri and employees, shall
comply in all respects with the ordinances of the ....... ........ - ...... of .... —Z
...... /�L . ......... ;that it does
not cover the use of public property, such as streets, sidewalks, alleys, etc., for which sptcial permits must be secured; and that it does
- - - - - --- - - - ------------_- _ . ...... ... ___
(Electrical work, plumbing, beating, plastering, etc., if such there be.)
for which special permits must be secured.1,
Given under the hand of the......... ............... of said ......................... c_
.............. ...................... and its corporate seal and
attested by its "this -u---day Of
Attu, t:
................. .........................
.......... . /L
................................... ....... ...... I.L . .............
not corer the following:.....
PROPERTY LINE
DIMENSIONS
Total square feet of floor area,
all f loors, based on exterior
di mensi ons ..... .
Total land area, sq. ft.
SPOT BUILDING/s SHOWING SET BACKS
PROPERTY LI NE
T
STREET
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 Building Inspectors.
APPROVED
VILLAGE OF SPRING, PARK APPLICANT
DATE: % DATE: -'