Permits - Permit# 562 - 2473 Black Lake Road - 1/1/1982PERMIT NO. S6 02.
CITY OF SPRING PARK
P.O. Boy 452
4349 Warren Avenue
Spring Park, MN 55384
BUILDING PERMIT APPLICATION
OWNER�L) V DATE 3�'- 07 7 - F,;�
ADDRESS S y 7 3 6 A41Z.L TELEPHONE L?29' - 3 57_3
BLDR--CONT TELEPHONEaS��
Location of Proposed Improvement
STREET ADDRESS
M
PLAT f,5- PARCEL ZONING,
COMPLETION DATE PIN
Application Requirements
r.
r
EST. C,OST
a
NO.
Survey. . . . , .. ✓' Energy Comp.,. . Heating Layout. . .
Plat Plan. . . . 7 Elevations .. . . Sewer/Water location.
Structural Plan... w,"Watershed . . . . County Driveway -permit. —
Other. . 4 .
Types of Construction
.dew Construction Remodeling
Single family Sq.
Multi family Sq.
Commercial Sq.
Industrial Sq.
Garage -size uX-�q.
Deck --size z ,M Sq.
Patio --size Sq.
Fence --size Ln.
ft.
ft.
ft.
f t .
ft. �qzn
f+
ft.
PERMIT FEE 5
SURCHARGE
PLAN CHECK FEE 96. rd
A - -
.Addition
Interior
Sub level
Roofing
Siding
Utility Bldg.
Sq.
Sq.
ft.
ft.
Sq.
ft.
Sq.
ft.
Sq.
ft.
Sq.
ft.
PERMIT APPROVAL
PLANNING COMMISS2 N
�. .C. COUNCIL
AVAIL. CHG.
OTHER OTHER PERMITS REQUIRED
TOTAL Sewer/Water. Connection
I Plumbing Excavation
31.� Demolition
In case .permit is granted, I hereby agree to do t eYi 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 �����z/ APPLICANT