Permits - Permit# 3-19-73 - 4333 Channel Road - 1/1/1973tom! Yit�✓ e'y2t�F
APPLICATION FOR. BUILDING PERMIT 64L�
VILLAGE OF SPRING PARK
SPRING PARK, MINNESOTA
Please Print or Type
OWNER (Name)
(Address) (Tel. No.)
PERMIT NUMBER
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V 1-7A 4"
ARCHITECT (Name)
(Address) (Tel- No.)
ESTI MATED COST
BUILDER (Name)
(Address) (Tel. No.)
PERMIT FEE
i_ r
$ o ").oas
DATE
PLUMBING FEE
LEGAL DESCRIPTION (Obtainable from Assessor's Office).
TOTAL
PLAT NUMBER PARCEL
NUMBER ZONING DISTRICT
$
COMPLETION DATE
y
PROPOSED USE—
NUMBER OF OFF—STREET
PARKING SPACES
Residential Nonresidential
Enclosed
/
I
One family — Amusement, recreational
Two family Enter
Outdoors
— or more — —
Church, other religious
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number of units ------
industrial
Transienthotel, motel, —
or dormitory — Enter number —
Par king Garage
SPACES REQ.
of units ---------- i —
Service station, repair garage
Garage _
Hospital, institutional
SPACES ON PLAN
Carport —
Of III ce, bank, professional
Other — Specify
Publ is Utility
School , library, other educational
NUMBER OF OCCUPANTS
OR SEATS
Stores, mercantile
Tanks, towers
OCCUPANTS
Other — Specify
SEATS
TYPE OF WORK
LOADING BERTHS
NEW CONSTRUCTION ALTERATIONS
ADDITION FI NI SH ATTIC
NUMBER REQUIRED
FINISH. BASEMENT PORCH - GARAGE
.y RE.ROOF __ RESIDE
/
NUMBER PROVIDED
MISC. v
SIZE OF EACH
SIZE OF STRUCTURE (Height) (Width, (Depth)
NO. OF STORIES
I
TYPE OF CONSTRUCTION P/-) Al g, 4 /'A/�
EXTERIOR FINISH
TYPE OF ROOF
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PRINCIPAL TYPE OF HEATING
PRINCIPAL TYPE OF FRAME
Gas
TYPE OF MECHANICAL
Masonry (wall bearing)
011
Gr.
Will there be central air conditioning?
Wood fame
Electricity
F'A'
Yes o
Structural. steel
Coal
Wtr.
Rai nforced concrete
Other — Specify
St ir:
Will there bean elevator?
Other —Specify
Yes _k:�! No
COMPLETE REVERSE) C'4/ '��' d
G ,
" /.
PROPERTY LINE
DIMENSIONS
Total square feet of floor area,
all floors, based on exterior
di mensi ons ..... .
Total land area, sq. ft.
SPOT BUILDING/s SHOWING SET BACKS
STREET
PROPERTY LI NE
SCALE: 1/8" 1 FT.
The undersigned hereby.represents upon all of the penalties
of law, for the purpose of inducing the Village of Spring Park
to take the action requested, that all statements herein are
true and that all work herein mentioned will be done in accor-
dance with the ordinances of the Village, Statutes of the State
of Minnesota, and rulings of the Building Inspectors.
1
APPROVED
VILLAGE OF SPRING PARK APPLICANT
DATE: DATE• �'-