Permits - Permit# SP18-14 - 3826 Budd Lane - 1/1/201810.
CITY OF SPRING PARK
PAGE 1 BUILDING PERMIT
4349 Warren Avenue
Ag
Spring Park, MN 55384
p 9
Handout Given
Phone: 952-471-9051 Fax: 952-471-9160
0 Lead Handout Given
SITE ADDRESS: 3826Budd Ln
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1) Was the home constructed before 1978? (YES ❑, continue with line
2, NO dcontinue without completing EPA Section)
2) Will the work disturb 26 sq ft of interior painted surfaces or a20 sq ft of exterior painted surfaces? (YES ❑ go to line 4, NO daine 3)
3) Are there any windows being replaced? (YES cKgo to line 4, NO ❑
continue without completing EPA Section)
4) Has this home been Certified Lead Free? (YES c� you MUST Attach Certification Information, NO ❑ complete line 5)
5) EPA Contractor Certification Number: NAT - 21315-2
(applies to contractor only)
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PROPERTY OWNER: Glenn & Marilyn LaBine
Address: 3826 Budd Ln
City: Spring Park State: MN Zip: 55384
Email:
Contact Name: Glenn & Marilyn
Phone: 701-213-2655
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CONTRACTOR: Minnesota Rusco, Inc
Address: 5010 Hwy 169 N
City: New Hope State: MN Zip: 55428
Phone: 952-935-9669 Fax: 952-935-9544
Contractor License No: CR002173
Contact Name: Michelle Heikes Phone: 952-935-9669
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Email: michelle@minnesotarusco.com
ARCHITECT:
Address:
City: State: Zip:
Phone: Fax:
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Email:
Contact Name: Phone:
TYPE OF WORK: ❑ New Construction
❑ Deck ❑ Re -Roof
❑ Commercial 9"fReSidential ❑ Change of Use
❑ Pool ❑ Re -Side
EST. VALUATION OF WORK ❑ Finish Basement
❑ Retaining Wall ❑ Fence
$ 7,303 ❑ Remodel
❑ Porch ❑ Shed
Square feet: ❑ Addition
❑ Demolition ❑WVindow/Door Replacement
❑ Garage-Attached/Detach
❑ Plumbing -provide detail on Page 2 # being replaced 2 entry door
Detailed Description of Work: ❑ Accessory Structure
o Mechanicl-provide detail on Page 2 ❑ Misc Other
Replace 2 entry doors into existing openings
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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. 1 hereby acknowledge that I have read this application and stale 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, specifications 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. 1 agree to pay all plan review fees even If 1 choose not to proceed with the work. Permit expires when work
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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,
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will be subject to a penalty.
Noise Ordinance In Effect: MONDAY - FRIDAY Before 7 a.m. and after 10 p.m. Weekends/Holidays before 7 a.m. and after 8 p.m.
SIGNATURE OF APPLICANT:
DATE: 5/`31/18
PRINTED NAME: Michelle Heikes
This Is the signature of: ❑ Owner or cXOwne(s Representative
OCCUP. TYPE: CONST. TYPE: CODE:
BLDG SPRINKLED Yes/No
VALUAT!ON: $
3s'-4WD
Permit Fee: $
WAC Charge: $
Plan Review Fee: $
Sewer & Water Hook -Up: $
State Surcharge: $
Sewer & Water Disconnect: $
Site Inspection Fee: $
Water Meter: $
S.E.C. Fee: $
Muni SE/WA Fee: $
Investigation Fee / Other Fee: $
•2016 SAC Escrow:
}
Copy Charge ($.25 per 8.5 x11 page) $
Other: $ W"
OLicense
Check ($5) / Lead Check ($5) $
TOTAL DUE: $
W
SUB -TOTAL $ 39, Sro
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Plumbing Fee (from Page 2) $
'NOTE: Commercial plans will be submitted to the Council Envlronmen Svcs
for SAC determination. Escrow payment will be require
W
U
Mechanical Fee from Page 2 $
after Met Council review no SAC Is determined, escrow will be refunded In full.
LL
Special Conditions/Required Setbacks:ILL
O
Building Approval By:
DATE:
Printed Building Approval By:
❑ License Verification ❑ Lead Verification - Checked By:
City Approval By:
DATE:
Paid: -f 3,?, P Date: Receipt No.
(al.53 B .
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A 4u
DEPARTMENT OF
LABOR AND INDUSTRY
License/Certificate/Registration Detail
Class Type:
RESIDENTIAL REMODELER
Number: CR002173
Application No:
199142
Status: ISSUED
Expire Date:
3/31/2020
Effect Date: 4l1/2018
Orig Date:
1/14/1992
Print Date: 5/28/2018
Enforcement
NO
Action:
Workplace
N/A
Experience:
Name:
MINNESOTA RUSCO INC DBA MINNESOTA SHOWER AND BATH AND MINNESOTA SUNROOMS
Address:
5010 HWY 169 N
BROOKLYN PARK, MN 55428
Phone:
952-935-9669 Fax: Other:
Business Relationship Requirements
Name:
HAZELWOOD, MICHAEL P
Lic/Reg No: OC721271
Status:
ISSUED
Application No: 375880
Expire Date:
3/10/2019
Effect Dale: 3/10/2017
Orig Date:
3/10/2017
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THIS CARD MUST BE VISIBLY POSTED, CITY of SPRING PARK Permit #
ACCESSIBLE, AND PROTECTED FROM
WEATHER AND PHYSICAL DAMAGE PERMIT CARD SP18-014
FOR THE DURATION OF THIS PERMIT.
( ALID FOR A SINGLE PROJECT)
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Site Address: 3" $ L,oAe, Building: >rt!�cdu'
Owner Name: G k a n + ryl au' I LA-' Vic, -
i
Contractor Name: Win n 0k0-- V—US
Contractor License: C 00 c� 17 3 Date Issued: to 8
REFER TO HANDOUT FOR INSPECTION REQUIREMENTS OFFICE USE
0 ROOFING 0 SIDING WINDOW DOOR HANDOUT
INSPECTOR: DATE: Issued by: Received by:
0 FENCE M SHED Front: Back:
INSPECTION: DATE: Side: Side:
MECHANICAL FIREPLACE PLUMBING COMMENT
ROUGH -IN: DATE:'' Pressure test forblumbina and hvdronic ainine
GAS LINE: DATE: Air test required for new Ptas line
FINAL: DATE: Gas line fittinp-testreguired -
MUST CALL TO. SCHEDULE NO. LATER THAN- I lit tsubimtbao UAT rRwR 1 v I ",I. IV 16% �
Permit will expire 180 days after issuance. All work must comply with. the MN State Buildino Code.
PHONE (952) "2-7520 MNSPECT. LLC TOLL FREE (888) "6-1801