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Permits - Permit# 16-35 - 2478 Black Lake Road - 1/1/2016 (2)_ CITY OF SPRING PARK PAGE 1 BUILDING PERMIT 4349 Warren Avenue /60 Spring Park, MN 55384 Handout Given Routed to MNSPECT Phone: 952-4477�1/-9051 Fax: 952-471-916/�0 Lead Handout Given SITE ADDRESS: Z- NI _ kit L./� c G r�wj PID: f (- I' / - a3 /o1- 0 1) Was the home constructed before 1978? (YES ❑, continue with line 2, NO ❑ continue without completing EPA Section) 2) Will the work disturb a6 sq ft of interior painted surfaces or 2:20 sq ft of exterior painted surfaces? (YES ❑ go to line 4, NO ❑ line 3) • 3) Are there any windows being replaced? (YES ❑, go to line 4, NO ❑ continue without completing EPA Section) 4) Has this home been Certified Lead Free? (YES ❑, you MUST Attach Certification Information, NO ❑ complete line 5) 5) EPA Contractor Certification Number: NAT - (applies to contractor only) PROPERTY OWNER: Address: L( %/'6-c � e�,­4_C City: G,w-e — y-A State: 1111(-- Zip: ss3 j/ Email: - �� Contact Name: r, Y r-' Phone: • CONTRACTOR: 441, Z'2 c Address: (/Lr��. 5 •� �� 5��� i City: State: Zip: 3 ( Phone: 6/,2 -_2 20 ' C-21 Fax: Contractor License No" • S Contact Name: Se f Phone: Email: S9 ARCHITECT:— Address: City: State: Zip: Phone: Fax: • Email: Contact Name: Phone: TYPE OF WORK: ❑ New Construction ❑ Deck ❑ Re -Roof ❑ Commercial ❑ Residential ❑ Change of Use ❑ Pool ❑ Re -Side EST. VALUATION OF WORK ❑ Finish Basement ❑ Retaining Wall ❑ Fence $ SiQ/I^ ,©d ❑ Remodel a' ❑ Porch ❑ Shed Square feet: ❑ Addition Apemolition ❑ Window/Door Replacement ❑ Garage-Attached/Detach ❑ Plumbing -provide detail on Page 2 # being replaced Detailed Description of Work: ❑ Accesso Structure ❑ Mechanical -provide detail on Page 2 ❑ Misc Other • Signature of this application by the legal property owner or a licensed contractor, as the owners representative, is required and authorizes the Zoning Administrator or designee and the Building Official or designee to enter upon the property to perform needed inspections. Entry may be without prior notice. I hereby acknowledge that I have read this application and state that all information is true and correct to the best of my knowledge. I further agree that all work performed will be in accordance with approved plans, specfications and conditions and to abide by all ordinances of the Municipality and the laws of the State of Minnesota regarding actions taken pursuant to this permit. I agree to pay all plan review fees even If I choose not to proceed with the work. Permit expires when work is not commenced within 180 days from date of permit, or if work is suspended, abandoned, or not inspected for 180 days. Work beyond the scope of this permit, or work without a permit or inspection, • will be subject to a penalty. Noise Ordinance In Effect: A ID Before 7 a.m. and after 10 p.m. Weekends/Holidays before 7 a.m. and after 8 p.m''. SIGNATURE OF APPLICA ll DATE: PRINTED NAME: / This is the signature of: ❑ Owner or wner's Representative OCCUP. TYPE: TQC - � CONST. TYPE: ►%- (3 CODE: 2a\ BLDG SPRINKLED Yes o VALUATION: $� Permit Fee: $ 2�2 �O WAC Charge: $ Plan Review Fee: $ \3-1 • �-\ Sewer & Water Hook -Up: $ State Surcharge: $ Sewer & Water Disconnect: $ Site Inspection Fee: $ Water Meter: $ S.E.C. Fee: $ SC9.<� Muni SE/WA Fee: $ Investigation Fee / Other Fee: $ *2016 SAC Escrow: 485 Copy Charge ($.25 per 8.5 x11 page) $ 5o Other: z0 License Check ($5) / Lead Check ($5) $ TOTAL DUE: $ W SUB -TOTAL $ Q S to _ Plumbing Fee (from Page 2) $ Council Environmental NOTE: Commercial plans will be submitted;��&�55ed. for SAC determination. Escrow payment wilIf W Mechanical Fee from Page 2 $ after Met Council review no SAC is determined, escrow will be refunded In full. V LL Special Conditions/Required Setbacks: LL O Building Approval By: ���� DATE: 10�\� b Printed Building Approval By: ❑ License Verification ❑ Lead Verification - Checked By: y Approval By: [Paid: DATE: 'Z A Date: /(7 as / Receipt No. 71 Cf� 7 By: Poor Quality Document Disclaimer The original or copy of a document or page of a document presented at the time of digital scanning contained within this digital file may be of substandard quality for viewing, printing or faxing needs. Office Use Only Plan Review Comment S #R16-369 Municipality: Spring ark Permit #:16-35 NAT #: Applicant: Homes by l Address: 2478 Black Lake Road Project: Demo _,__ Valuation: $ S D00 SEC: NO Is septic an issue? NO Owner permission needed? No Date Issued: \106- to Inspector Issued: CY\" Number of Days: Date & Comments 10/06/16 Received application and plans TS �a`l,`�(, �b.� ��v►w �� �Q Carta 11 Municipality plans at MNSPECT � Date Received at City Hall: Demolition Property Address: Type Of Structure: Approx Date To Begin: I Application For Demolition Permit Permit #: City of Spring Park, Minnesota j� 'a d �,`'z ...k''r� o�':""sue ar' P ,, valuatlon and Requ:res a B01drni Permft Telephone No.: (o 12 — Z % l 5 a (M Utilities On Site: Check (✓) all that apply Sewer Water Electric <� Cable Gas �_ Telephone Note: It is the Owner's or Contractor's responsibility to contact GOPHER STATE ONE CALL at 1-800-252-1166 to notify of the disconnect and to mark any underground utilities on the property. Will Utilities Be Used For New Structure? .................. Yeses/_ No Note: If water and sewer services are never to be reused, the property owner is responsible for abandoning services according to Minnesota State Plumbing Code and must be inspected by the City of Spring Park Public Works Department. Is There a Water Well On Site? .................................... Yes No Is There An Underground Fuel Tank? .......................... Yes No Demolition Contractor: 6&1-rK 4LT,,V,' $ ��/lf� /�j Telephone No. 7 — / 3 Address: � O �(fdN,��� �2� (/'" �.�I � / %� �' e �h r Liability Insurance Co &,)ar -I,)C�� Telephone No. Policy No: q� Policy Period From: To.. Coverage And Limits: 3, txo � Note: In the event that any ASBESTOS is present in the structure, state approved methods must be followed. I hereby declare that I am the owner of the VQperty or the demolition contractor of above described property. I agree to comply with all state regulations and all materials fro 'tion will be taken to a state approved demolition dumpsite. All the foregoing information contained on this permit is a e' con atement of my i nhon . Signed By Applic Date: Z lip Permit Approved By: Title: Date: The Following Section To Be Completed By City Officials Total Fee: Receipt No: Received by: The Following Section To Be Completed By Public Works / Operator Water Service............ Disconnected Abandoned Sealed Signed Sewer Service............ Disconnected Electrical Service ...... Disconnected Gas Service ............... Disconnected Abandoned Sealed Signed Abandoned Removed Signed Abandoned Removed Signed Page 1 of 2 All of the foregoing requests must be completed and signed -off PRIOR to the start of any demolition. The undersigned owner/contractor hereby agrees as follows: 1. The structure shall be kept enclosed and/or secured until such time as demolition is complete. 2. Demolition debris will be kept off adjoining property and/or the public rights -of -way unless specific, prior approval is obtained in writing for temporary use thereof. 3. Foundations shall be completely removed from the ground. 4. All demolition debris shall be completely disposed of off site in accordance with all applicable PCA requirements. 5. Water wells must be abandoned in accordance with the State, Health Department regulations. 6. Inspection required when all debris has been removed — before backfilling. 7. Within five working days of superstructure removal, a final inspection shall be requested. The site shall be left clean and clear of all debris, with any excavation filled with earth level with the adjacent ground elevation (except when such excavation is to be used as part of a new building and such new building is actually under construction). 8. Septic systems must be abandoned per MN Rules Chapter 7080. All septic tanks must be pumped, crushed and filled with native soils. An inspection is required after the tanks are pumped and before the tanks are crushed and filled. 9. The undersigned owner shall and hereby does indemnify and hold harmless the City of Spring Park, its agents, employees and assigns from and against all claims, damages, losses or expenses, including attorney fees, against the City, its agents, employees and assigns arising out of or resulting from the demolition described herein as performed by the property owner, his employees, agents, subcontractors or assigns. The undersigned hereby applies to the City of Spring Park for issuance of a Demolition Permit, agrees to do all the work in a strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made on this application are comp;te� rue and correct. Applicant's Signature Owner's Signature Approved By: Page 2 of 2 INSPECTION RECORD 02015 Minnesota State Building Code In 2006 Minnesota State Building Code PERMIT NUMBER 1 � 135 DATE xQ \\ 6 CALL FOR ALL INSPECTIONS 24 HOURS IN ADVANCE 8:00 A.M. to 4:30 P.M. Monday thru Friday 9 5 2- 4 4 2- 7 5 2 0 Site '� ` REQUIRED INSPECTIONS ARE CIRCLED � Address: ����� �1�OlC� \t3�Q tDate Inspector Description: ec sa. Permission is hereby granted to: Owner: \�OrnaS �_esx-_`Rs ICE f' Address: Z wo���cr to install or construct the improvements applied for. This permit is M granted upon the condition that the person to whom it is granted, and his Fina agents, employees and workmen, shall conform in all respects to the Ordinances of the Municipality of SR r:n+6 and to the Statues of the State of Minnesota in §dch cases made and provided; this permit may be revoked at any time upon violation of any of the provisions of said Ordinances, Statues, or for any misrepresentation in the application. This card and reviewed construction plans must be posted at the worksite and maintained until all inspections have been approved. NO INSPECTION will be performed if card and plans are not available to inspector. REINSPECTION FEE WILL BE CHARGED. NO DEVIATIONS FROM THE APPROVED PLANS ARE ALLOWED WITHOUT PRIOR CONSENT FROM THE BUILDING INSPECTIONS DEPARTMENT. Do not occupy until all final inspections have been completed. Permit expires when building and work Is not commenced within 180 days or If building and work Is suspended, abandoned or not Inspected for 180 days. MECHANICAL & PLUMBING INSPECTIONS Date Inspector Plumbing Rough In Plumbing Final Heating Rough -In GAS LINE Heating Final Fireplace Rough -In GAS LINE Fireplace Final Electrical Rough -in Note: Permit holder Is responsible to call for these Inspections. Electrical Final Municipality File t Demolition Requirements, Residential Building Removal Read All Attached Materials! EVERY PERSON PERFORMING WORK FOR WHICH THE CODE IS APPLICABLE, MUST COMPLY WITH THE CODE (MRC 1300.0120, Subpart 14). Post Address on Construction Site, Visible from the Road (MSFC 505.1) ACCESS TO ON -SITE FIRE HYDRANTS SHALL BE MAINTAINED (MSFC 508.5.4). PORTABLE FIRE EXTINGUISHERS SHALL BE INSTALLED IN ACCORDANCE WITH THE MINNESOTA FIRE CODE AND AS REQUIRED BY THE FIRE CHIEF CONTACT GOPHER STATE ONE PRIOR TO EXCAVATION (MN Statute 21613.04, Subd. 1) Waste Materials shall be removed in a manner which prevents injury or damage to persons, adjoining properties, and public rights -of -way (MRC 1305.3302.2). The work of demolishing any building shall not be commenced until any required pedestrian protection is in place (MRC 1305.3303.2) SUBJECT TO CODE COMPLIANCE DURING CONSTRUCTION REVIEWED FOR CODE COMPLIANCE BY DATE A, CONSTRUCTION EQUIPMENT AND MATERIALS SHALL BE STORED AND PLACED SO AS NOT TO ENDANGER THE PUBLIC, THE WORKERS, OR ADJOINING PROPERTY FOR THE DURATION OF THE CONSTRUCTION PROJECT (MRC 1305.3301.2). Hazardous Materials and contents are to be removed per MN Rule 7035.0805. All materials removed must be properly characterized, tested, managed, and disposed of, reused, or recycled in accordance with applicable standards. WHERE A STRUCTURE HAS BEEN DEMOLISHED OR REMOVED, THE VACANT LOT SHALL BE FILLED AND MAINTAINED TO THE EXISTING GRADE [MRC 1305.3303.41. Any wells, septic systems, or underground storage tanks must be removed, abandoned, or filled as allowed be MN Statute. All utilities must be properly terminated prior to starting demolition. FOR ALL INSPECTIONS: No, CALL 24 HOURS IN ADVANCE ►GIVE PERMIT NUMBER \6 -S5 (952) 442-7520 Checklist for Demolition Permit nn �� be Wuded when applying for permit} Project Name: 2-4-8 ` L AC,L L-Pd-C- 2a�,o Date: 9 1 2� t Address: 74110>�e.14 _( KtF. ;� Municipality: 5 e r irv1. VPOAAk Owner's Name: Telephone. Number: G I2 -Z11 o - G2-( q Contractor's Name: Rpwc%. 13S Telephone Number: Detailed explanation of work to be performed: J),FLwwLA-%4-1 c.-" "AA-ii- To' Liwiio f1LL, t 0 S'fn4LL 5� �—� 1N c �vepnl �rr,c ?o r r2,w c� t ►� Lc7 7 . _�1e Low � ►J �c�,�-t .oF c�T Have the following- been submitted or completed? Yes No NIA ❑. ❑ Completed permit application. ❑. ❑ Two setsof site plans verifying the location and size of structure(s) being demolished. ,E]-- ❑ ❑ Two sets of plans showing area of interior/exterior demo work. ja ❑ ❑ A written description of building demolition method. ❑ ❑ A written verification and/or site plan identifying the type of pedestrian protection being provided, including description of type, location and height of fencing- to be used. ❑. ❑ E3-.A performance -bond, letter of credit, escrow or securities in accordance -with the Municipality policy. ❑ ❑ A Notification of Intent to Perform a Demolition submitted to the Minnesota Pollution Control Agency. (Under Section 40 of the Code of Federal Regulations Part 61(M), if the structure is regulated, you must submit a Notice of Intent to Perform a Demolition. Single family dwellings are generally exempt.) ❑ ❑ All utilities properly terminated.. All wells properly abandoned in accordance with State Health Departmgttjggulat_onsr.., ❑ ❑ Septic tanks pumped and removed. ❑ ❑ Are there any underground storage tanks to be removed?(dance (re-lino ZA �ICGhwl t. ❑ ❑ All hazardous materials removed and disposed of in acco with innesota Pollution Control Agency requirements. See the MPCA documents Pre-Renovation/Demolition Envir-onmental Checklist and Pre -Renovation- or Demolition Requirements (attached) for more inf mla--b . i Date /z---7 (Structures) Page 2 of 9- Revised May-201 G f LEGAL DESCRIPTION: Lot 3, SKARP AND LINDQUIST'S ROSE HILL, Hennepin County, Minnesota. SCOPE OF WORK & LIMITATIONS: 1. Showing the length and direction of boundary lines of the legal description listed above. The scope of our services does not include determining what you own, which is a legal matter. Please check the legal description with your records or consult with competent legal counsel, if necessary, to make sure that it is correct and that any matters of record, such as easements, that you wish to be included on the survey have been shown. 2. Showing the location of observed existing improvements we deem necessary for the survey. 3. Setting survey markers or verifying existing survey markers to establish the comers of the property. 4. Showing and tabulating impervious surface coverage of the lot for your review and for the review of such governmental agencies that may have jurisdiction over these requirements to verify they are correctly shown before proceeding with construction. 5. Showing elevations on the site at selected locations to give some indication of the topography of the site. We have also provided a benchmark for your use in determining elevations for construction on this site. The elevations shown relate only to the benchmark provided on this survey. Use that benchmark and check at least one other feature shown on the survey when determining other elevations for use on this site or before beginning construction. 6. Note that all building dimensions and building tie dimensions to the property lines, are taken from the siding and or stucco of the building. STANDARD SYMBOLS & CONVENTIONS: "41" Denotes iron survey marker, set, unless otherwise noted. EXISTING HARDCOVER House 946 Sq. Ft. Existing Deck 252 Sq. Ft. Concrete by garage 361 Sq. Ft. Bitusinous 570 Sq. Ft. Garage 451 Sq. Ft. Concrete by lake 216 Sq. Ft. Porch 290 Sq. Ft. Rot. Walls 221 Sq. Ft. TOTAL EXISTING HARDCOVER 3,327 Sq. Ft. AREA OF LOT TO ONW 8,869 Sq. Ft. PERCENTAGE OF HARDCOVER TO LOT 37.5-+ LEGEND Wi = CATCH BASIN = FIRE HYDRANT = POWER POLE ® = MANHOLE ® = TELEPHONE PIED. 8 = ELEC. TRANSFORMER ® = WELL ® = GATE VALVE = LIGHT POLE —X—X— = FENCE LINE —SS — = SANITARY SEWER LINE —W— = WATER LINE G = GAS LINE ST = STORM DRAIN LINE E = OVERHEAD UTILITY LINE - CONCRETE SURFACE )0� X 944.8 M"3.7 1�7 'D V74 / td id1E Ot 4 6& �O DATE I RENSiON DESCBiPnON DRAWING ORIENTATION L SCALE CLIENT NAME I JOB ADDRESS I tit QRTFI THAT TH5 PLAN. S RVCt REPORT SHEET TITLE SHEET NO. // AND THAT I A A IE OR OST R I) SECT 9iVOR Advance M� THAT A aAT ��� ,MNN EXISTING CONDITIONS HOMES BY LEGACY' ues v E W[SOTA GATE SURVE�'ED � AUGUST 25, 20111 SURVEY ^ N Surveying B Engineering, Co. `V 0 20 2478 BLACK LAKE ROAD komeaM Ba— DRAWMIMBER SPRING PARK, MN 5300 5o n "" No 10t $ 42379 DATE DRAF'EO AUGUST 25, 2016 INO Mnnatenks, M,nnassts 55345 ixxNac No 160728 TB Phone (952) 474-7964 AUGUST 25. 2016 Web _am.w.— snEE* of t 2478 Black Lake Road, Spring Park 1 Ir e Go to Natural Resources links Clear results � � _ PID: 1911723120021 L , { 1 Jf ♦ ���,tl� ,.. , .} .. •c '_ r '- ��-• :+:..• '' ��� . • :�Ei �4Y .R .iY. '•il `1 I ' �`+ . t ��, ' 2478 BLACK LAKE RD �, 4 : Address: ► �•. SPRING PARK.55384 ,.�''�d►�'(F'' Owner Name: DENNIS J CAN rAELL Acres: 0.21 Click inside the selected parcel for detailed Fcint results and m �s �° - \ +ti* �1 �✓ }� coordinates ;� Click the items with a + below to view results .. IF � �•., �; II9 +Land Cover Present ,� •.•• '� ���.� t No Ecologically Signif. Area Present y }Ax No Natural Resource Corridor Present Q + Soils Present.<. F - - S y No Conservation Easements Present;► • °. ;.t ♦ fie¢, t ,.. � - No DNR Public Waters Present + Floodplain Present No Wetlands Present No DNR Infested Waters Present No MPCA Impaired Waters Present ' t' + Watershed Present