Permits - Permit# 05-14 - 2473 Black Lake Road - 1/1/2005w:
*'- FROM CITY OF SPRING PARK (THU) 4 21 2005 16 :17/ST. 16 :17/NO. 5011475535 P 1
CITY OF SPRING PARK
4349 WARREN AVENUE
SPRING PARK, MN 55384
952.471-9051 FAX 952-471-9160
BUILDING PERMIT APPLICATION
Building P", it Application Requirements:
1 1. A.0pllcation to be filled out & signed
i 2. Mechanical Permit Application 8 Calculation filled out
,vA 3. Energy Calculations filled out
14. Furnish a Certificate of Survey - See Attached
5. Furnish 3 sets of Construction Plans
a)1 set for City files
b)1 set for builder to use on site
c►1 set for City Building Inspector
Construction Plans should Include:
1. First floor plan
J 2. Footing A foundation plan
✓ 3. Elevations of all sides
4. Wall sections & cross sections
S. Details - stairs & any special connections
Date Received
Date Approved G�
Permit No. '7 `
Fees To Be Charged:
Permit b5? qs
State Surcharge z 1 .00
Plan Review '3 b 5. 9 2-
SAC Charge
Availability Chrg
TOTAL q q q. $-)
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
THE APPLICANT 13 (CIRCLE ONE) OWNER OR CONTRACTOR
JOB SITE ADG aESS 6 �, s �` ► n Perk .
NAME OF
MNL1N0 ADDRESS] 6 1 a V • CITY =
CONTRACTOR �L 1�, \O CA) C .10c` .i11C 5 YP1 ONE
MAILING ADDRESS 1 ID 3 01 d A W y $
1CITY _
STATE LICENSE NO. 15 , -I h / tl
PHONE d WORK PHONE rx he
5 h n zip 394
MOBILE PHONE
ZIP 5�l
ARCHITECTIENGINEER PHONE
MAILING ADDRESS
CITY ZIP
NAME j� REGISTRATION NO.
TYPE OF WORK: NEW ADDITION ACCESSORY STRUCTURE MOVE DEMO
REMODELIALTERATION RE VATS LAND ALTERATION
PROPOSED WORK (Describe In DeNIQ SAM 0A/ )(9,9 x '
F N �0 wa-o'�
ZONING DISTRICT
STORIES �_ SQ. FEET OR EACH FLOOR 3L4 9 No. OF BEDROOMS GARAGE STALLS
1
ATTACHED _ X OR DETACHED BLDG. SIZE:LENGTH 2�-�Q 1( WIDTH � HEIGHT
ESTIMATED CONSTRUCTION VALUATION (exciud" land) 1 I 79
• Cf —
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►.` :;FROM CITY OF SPRING PARK (111U) 4 21 2005 1G:18/SI. 1G:I /fJU. 5U1141553� N 1
ILDING PERMIT APPLICATION
HARDCOVER CALCULATION WORKSHEET
A. House X - / 0 S.F.
Length IMdth
I. X a O S.F.
B. Garage X tV S.F.
C. Driveway 1 �x S.F.
x
D. Sidewalk x a S.F.
x S.F.
E. Patio/Deck x
F. Outer x S.F.
1. TOTAL HARDCOVER -,7 t q i Q _S.F.
2. TOTAL. PROPERTY AREA S g S.F.
t DIVIDED BY Z X 100 = S %
I heteby apply lot a bunding pemtft and 1 ackrrvwfedge that thc'--'ornutlon above Is complete and accurate; flint Ihs work will be In conformance
with go ordinances and codes of Ow City and with die state RuIldIng Code; amt 1 urrcrerrtand Oils Is not s Penrrt and work Is not to start wlthotA
a pencil; and that the work will be In accordance what the approved plan.
APPLICANT'S SIGNATURE DATE �;
INSPECTION REQUIRED; WORK REQUIRINU SEPARATE PERMITS:
9c Footing before a pour Plumbing
K Framing rough -In Mechanical
Insulation TWell
Wallboard before taping Grading & filling
�C NAL before occupancy Sewer
Water
WORK BEYOND OR WITHOUT A REQUIRED
INSPECTION WILL BE SUBJECT TO PENALTY X Electrical from State
24 HOUR NOTICE REQUIRED CALL 952-249.4600
ZONING OCKTIEWATE
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 Pailk and will be approved for construction upon
approval of the construction plans by the Building Official.
Name __ _ _
Date
Name LVU"e"— Dale 5' 2, - 0-5-
Form No. 259 141 .. i7 l� Election Systems and Software 1-800-800-8225
Perfnit $562.95
Plan Rev 36 .92
'State* ..... 21- :00
Total 949.87
J�tutc of Minnesota,
County of.....Hennepin
...................
TO
N11...05:14........
�i.t:y.....of ..S 'wing.Park ...............
Office of ...B':ilding Insnector
...................
!ding rjertnit
IN CONSIDERATION OF The statements and representations made by ......................
.....................Pat.io. Enclo.su.re.s.,. I.ric..
.........................................................
in application therefor duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY
GRANTED To said ..Patio Enclosures, Inc
.....................................................................as owner
Install four season sun ruorl per .......................... ..xt inn
uopl....a building described as follows: kind of construction
to ...........
(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 ................
2473 Black Lake Road 19-117-23-12-0025
....................................................................................................
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 i.5... contractors, agents, workers and
employees, shall comply in all respects with the ordinances of the ... City of Spri r.. 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 following
(Electrical work, plumbing, heating, plastering, etc., if such there be.)
for which special permits must be secured.
Given under the hand of the g I.n s o ec to r , of said .....City ..... , .. and its corporate seal and
attested .by its .. Clerk this .lit ..... day of June .2005
.................. Year.........
Attest:
Williao.0. We`ek'......��Cj L le Oflan.............. � .............
Builriin I�isoector
Clerk �: +