Permits - Permit# 96-13 - 4317 Channel Road - 1/1/1996w
CC� OF SPRING PARK
CITY OF SPRING PARK
P. 0. E30X 452
BUILDING PERMIT APPLICATION S'!"F:NG PARK, MN 55384-0452
Building Permit Application Requirments:
1. Application to be filled out & signed
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:
Date Approved: G/17
Permit No.: 9� --/3
Fees To Be Charged:
Permit $
State Surcharge /. 15-0
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) OWNER or CONTRACTOR
JOB SITE ADDRESS 4317 uNe` /7?oacC
NAME OF OWNERN HOME PHONE'WORK PHONE 94 "
MAILING ADDRESS 43/ 7(e. /ZQ CITY ` RAA mw. ZIP S 3 7
CONTRACTOR
MAILING ADDRESS
STATE LICENSE NO.
ARCHITECT/ENGINEER
MAILING ADDRESS
NAME
TYPE OF WORK:
New Addition —
Remodel/Alteration X—
PROPOSED WORK (Describe in Detail)
_ PHONE
MOBILE PHONE
ZIP
ZIP
Demo
4-o &� r z� v�
ZONING DISTRICT
STORIES
CITY
PHONE
CITY
REGISTRATION NO. _
Accessory Structure Move _
Renovate Land Alteration
SQ. FEET OR EACH FLOOR NO. OF BEDROOMS GARAGE
STALLS ATT. OR DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land) $
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Valuation $2500
Form No. 259
BUSINESS RECORDS CORPORATION, MINNESOTA
Permit $74.75
State 1.50
• Tota.l.... $.76.,25.. .
III. ,96-1.3 ........ .
#tote of fl[inneoo#o, lty...... of. .Spring Park ...........
County of ... Hennepin Office of . Building Inspector
IN CONSIDERATION OF The statements and representations made by ......................
.......................John Headlee............................................................. ...
in application therefor duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY
John Headlee
GRANTED To said.........................................................................as owner
Tear off and re -roof er application a building described as follows: kind of construction
to..........................P.......
(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 ................
4317 Channel Road 19-117-23-12-0033
....................................................................................................
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 . Spy i ng, ,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:.. We. Of. the, fo 1 l oW.09......................... . ..... .
(Electrical work, plumbing, heating, plastering, etc., if such there be.)
for which special permits must be secured.
Given under the hand of the DOIOd Pg. 105PPM)r... of said . City ................ and its corporate seal and
attested by its ..... 1 erk.............. this . 18t................... day of . QUne .................. 19 9Q ...
Attest:
Patricia Higus C' �........ , .. .
Clerk
.......Lyle Oman.... 4(0 ...................
.Bui.ldi.ng Inspector
r 4a
CITY OF SPRING PARK
BUILDING PERMIT APPLICATION
PAGE 2
HARDCOVER CALCULATION WORKSHEET
A. House X
= S.F.
Length Width
X
= S.F.
B. Garage X
=
C. Driveway X
= S.F.
X
= S.F.
D. Sidewalk X
= S.F.
X
— S.F.
/
E. PatiQ/ X�
= S.F.
Deck
F. Other X
= S.F.
/
X
= S. F.
1. TOTAL HARDCOVER
S.F.
2. TOTAL PROPERTY AREA
S.F.
1 _ 2
X 100 =
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work
be
will in conformance with the ord' s and codes oft the City and with
the State Building Code; that I understand this is
not a permit and work is not to rt with ut ermit; d hat the wor
ill be in accordance with the proved Ian.
%< 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
CITY OF SPRING PARK
BUILDING PERMIT APPLICATION
ADDENDUM
Construction Plans must also include a Landscape Plan if applicable.
Certificate of Survey must include:
1. Location of the proposed building in relation to lot lines
2. Other buildings on the property
3. Buildings on adjoining properties in relation to lot lines
4. Location of street(s)
5. Location(s) of all easements on the property
6. Buildings in relation to the ordinary high water mark of 929.4'
if applicable
Survey must be current depicting all existing structures and
including all of the above information.