Permits - Permit# 98-34 - 2478 Black Lake Road - 1/1/1998t
CITY OF SPRING PARK CITY OF SPRING PARK
BUILDING PERMIT APPLICATION P. o. BOX 452
SPRING PARK, NiN 55384.0452
Building Permit Application Requirments:
1. Application to be filled out & siggned
2. Mechanical Permit Application & Calculation filled out
3. Energy Calculations filled out
4. 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
2. Footing & foundation plan
3. Elevations of all sides
4. Wall sections & cross sections
5. Details - stairs & any special connections
Date Received: �- 9
Date Approved:
Permit No.:
Fees To Be Charged:
Permit $
State Surcharge
Plan Review
SAC Charge
Availability Chrg
TOTAL
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
THE APPLICANT IS: (Circle One)
JOB SITE ADDRESS
OWNER or / CONTRACTOR
' Aj C4, /1��GG�7
'9&- a -5-�
NAME OF OWNER �/1/N!s / 7�N,&OME PHONE WORK PHONE
MAILING ADDRESS�7n �J`�'�� '` CITY���"� Ir ZIP
CONTRACTOR Iq A _ PHONE 976 23 MOBILE PHONE
MAILING ADDRESS (-11f117kt11 Ay CITY -7 L ZIP
STATE LICENSE NO.
ARCHITECT/ENGINEER
MAILING ADDRESS
NAME
TYPE OF WORK:. New Addition
Remodel/Alteration
PROPOSED WORK (Describe in Detail)
ZONING DISTRICT
PHONE
CITY
REGISTRATION NO.
Accessory Structure Move , Demo
Renovate Land Alteration
7101
STORIES SQ. FEET OR EACH FLOOR NO. OF BEDROOMS
STALLS ATT. OR DET. L W.
ZIP
HT
GARAGE
ESTIMATED CONSTRUCTION VALUATION (excluding land) $
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TY OF SPRING PARK
?►11LDING PERMIT APPLICATION
PAGE 2
HARDCOVER CALCULATION WORKSHEET
A. House
X
= S.F.
Length
Width
X
= S.F.
B. Garage
X
= S.F.
C. Driveway
X
= S.F.
X
= S.F.
D. Sidewalk
X
= S.F.
X
= S.F.
E.
Deck/
X
= S.F.
F. Other
X
= S.F.
X
= S.F.
1.
TOTAL HARDCOVER
S.F.
2.
TOTAL PROPERTY AREA
S.F.
1
T2
X100= %
I hereby apply for a building permit and I acknowledge
be
that the information
above is complete and accurate; that the work
will in conformance with the ordinances and codes of the City and with the State Building Code; that I understand this is
not a permit and work is not to start without a permit; and that the work will be in accordance with the
approved plan.
APPLICANT'S SIGNATURE
DATE
INSPECTION REQUIRED:
WORK REQUIRING SEPERATE PERMITS
Footing before a pour
Plumbing
Framing rough -in
Mechanical
Insulation
Well
Wallboard before Taping
Grading & filling
FINAL before occupancy
Sewer
WORK BEYOND OR WITHOUT A REQUIRED
Water
INSPECTION WILL BE SUBJECT TO PENALTY.
24 HOUR NOTICE REQUIRED
Electrical from State
473-7357
ZONING CERTIFICATION
I 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 Park and will be approved for construction upon approval of the
construction plans by the Building Official.
Name Date
BUILDING CODE PLAN REVIEW
Name Date
Form No. 259—(Re�. 6-10-80) Valuation $ 3000
Permit $ 74.75
State $ 1.50
Iota.l......... $... 76-: 25......
ffita-te of , iIntroiata,
County of ............. Hennepl.n........... ..................
6tiller-Davis Co.,
city ................of Spri ng Park ........................................
Office of ...... Bu i I d i nq....1 nspector.................................
IN CONSIDERATION OF The statements and representations made by...........................................................................
N B R (Dennis Cantwell)
.............................................................------..............................._.......................................................................................................................
in h 1 s application therefor duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY
GRANTEDTo said ................................... ReRRis... Caritwal.l........................................................................................................................................................ as owner
tear off and re -roof era lications
to.......................................................................P............PP-.............-.......... ............................................. a building described as follows: kind of construction
(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 .........................................................
2478 Black Lake Road 19-117-23-12-0021
...................................................................................•-.............................................................. -
which tract is of the size and area specified in said application.
This permit is granted upon the express conditions that said owner and hi-5 --- contractors, agents, workers and employees, shall
comply in all respects with the ordinances of the ......... Citiy........................................................of...-.....Sp.r-.ing...Pa-r-k-----...............--.......--.-- that it does
not cover the use of public pro erty, such as streets sidewalks, alleys, etc., for which special permits must be secured; and that it does
not cover the following:lone of the fo. �owing
(Electrical work, plumbing, heating, plastering, etc., if such there be.)
for which special permits must be secured.
Given under the hand of the........... Bu .l d. n9....1.n.��� ��.r...................of said ........ C 1 ty .and its corporate seal and
attested by its........Clerk.......... this ......
12th..............................day of ........... .Atlg.U.St ...................................... ............................ I9.9.8........
Attest:
Patricia...H.i.qus.. / I�1.1.�....Rrnan ............�:%
..................... ....---........----------......................
Clerk Building Inspector
.................................................................•--•-.