Permits - Permit# 01-24 - 4325 Channel Road - 1/1/2001CITY OF SPRING PARK
P. O. BOX 452
4349 WARREN AVENUE
SPRING PARK, MN 55384
952-471-9051 FAX 952-471-9160
BUILDING PERMIT APPLICATION
0— l
Building Permit Application Requirements:
Date Received
1. Application to be filled out & signed
Date Approved o
2. Mechanical Permit Application & Calculation filled out Permit No.
3. Energy Calculations filled out
4. Furnish a Certificate of Survey - See Attached
5. Furnish 3 sets of Construction Plans
Fees To Be Charged:
a) 1 set for City files
Permit /// P s'
b)1 set for builder to use on site
State Surcharge 9 ..S'
c)1 set for City Building Inspector
Plan Review
Construction Plans should include:
SAC Charge
1. First floor plan
Availability Chrg
2. Footing & foundation plan
�/ 3 %S
3. Elevations of all sides
TOTAL •
4. Wall sections & cross sections
5. Details - stairs & any special connections
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
THE APPLICANT IS (CIRCLE ONE) OWNER OR
CONTRACTOR
JOB SITE ADDRESS r i&'//
c�
IZ"/ / c- i/ ;;� - 3 - a , G G.3 /
NAME OF OWNER
HOME PHONE ^/1i4 WORK PHONE
n/LJS
MAILING ADDRESS/ �S '� .a��G/ 12
CITY S�P��itGi i�ir' ZIP
CONTRACTOR 1J7YJL1f�
PHONE li6a MOBILE PHONES
MAILING ADDRESS i�0 w 4 S'/' _ �,.,� /43
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CITY /I�✓I ZIP _3 `1P"
STATE LICENSE NO. -)0/6 WAA
ARCHITECTIENGINEER PHONE
MAILING ADDRESS
CITY
ZIP
NAME REGISTRATION NO.
TYPE OF WORK: NEW ADDITION ACCESSORY STRUCTURE MOVE DEMO
REMODEL/ALTERATION RENOVATE LAND ALTERATION
PROPOSED WORK (Describe In Detail) / /looms
ZONING DISTRICT
STORIES SQ. FEET OR EACH FLOOR NO. OF BEDROOMS GARAGE STALLS
ATTACHED OR DETACHED BLDG. SIZE: LENGTH WIDTH HEIGHT
ESTIMATED CONSTRUCTION VALUATION (excluding land) $
r
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PUILP,,ING 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. Patio/Deck X = S.F.
F. Other X = S.F.
1. TOTAL HARDCOVER S.F.
2. TOTAL PROPERTY AREA S.F.
1 DIVIDED BY 2 X 100 = %
I hereby apply for a building permit and I acknowledge that the information above Is complete and accurate; that the work will be 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 _ S' DATE
INSPECTION REQUIRED: WORK REQUIRING SEPARATE PERMITS:
Footing before a pour Plumbing
Framing rough -in Mechanical
Insulation Well
Wallboard before taping Grading & filling
FINAL before occupancy Sewer
Water
WORK BEYOND OR WITHOUT A REQUIRED
INSPECTION WILL BE SUBJECT TO PENALTY Electrical from State
24 HOUR NOTICE REQUIRED CALL 249-4600
ZONING CERTIFICATE
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 11 a l l l a t i n n t r, n n n
BUSINESS RECORDS CORPORATION, MINNESOTA
Permit $ 111.25
State $ 2.50
T•ota 1. • .. $- .1-13.75
MU. ...............
#tate of Minnesota, ... City..... of .. S p.r. in g ..P. a r k .........
County of ... Hennepin ............ Office of ...Bui lding Ins.pecto.r
Nuffb-n#
IN CONSIDERATION OF The statements and representations made by ......................
Amek Construction
....................................................................................................
in application therefor duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY
GRANTED To said .... Am.e k , C o,n $ t r u,e t i OR ................................................... as owner
to ... T e a r.. 0 f f , a n.d , Re - R.o of. . p e.r . a.p p I.i. c a.t, i on ............ a huild►ng described as follows: kind of construction
(build, erect, install, add to, alter, repair, move, wreck, as the rase 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 ................
.........4325..Chan.ne 1. RQ4d.... 19-.1.17-2.a-. 12-.0034...............................................
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.S .. contractors, agents, workers and
employees, shall comply in all respects with the ordinances of the ... C i t.y............. of .. Sp -ring. •Park • • • • • ;
that it does not cover the use of public property, such as streets, sidewalks, alleys, etc., for which special permits must
he secured; and that it does not cover the following: .. None of Lhe f o 1 1 ow i n.. ....................... .
(I-Aectrlcal work, plumbing, healing, plastering, etc.., if such there be.)
for which special permits must be secured.
Given under the hand of the . B u i 1 d i . .... ... I n s .p e c toc5f said ... C,i •t y, , , , • , • , , . , .. , and its corporate seal and
attested by its .. C 1 e r k ......... this .. ? 9 t h ................day of ..A u g u s.t .............. 200.1....
Attest:
........... W,i.1.liam.Q...Week.s........
(/���..
Clerk
...... Lyle Oman .... `��..................
B u.i.1. d i n.g..1 n 5•1)e G t o.r