Permits - Permit# 10-15B - 4341 Channel Road - 1/1/2010 (2)While You Were Out
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CITY OF SPRING PARK
4349 Warren Avenue Spring Park, MN 55384
Phone (952) 471-9051 Fax (952) 471-9160
BUILDING PERMIT
Noise Ordinance In Effect:
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Monday - Friday before 7 a.m.
and after 10 p.m.
Weekends/Holidays before 7
a.m. and after 8 p.m.
DATE — ���
CHANGES TO APPROVED BUILDING PLANS MUST HAVE CITY APPROVAL
• 7 PID
SITE ADDRESS C AiVM� L 1 /!A
OWNER Name /A r /State/ Zio
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CONTACT NAME - PHONE - EMAIL - FAX
ARCHITECT If R uir m/ Address / itv i/ Phone
CONTRACTOR Name/Address / Ci / a / Zi / Ph n
/ La ke -fT T-
MilW
'95- (0 3c,c)
CONTACT NAME -PHONE- EMAIL -FAX %Z SS �jn
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CONTRACTOR LICENSE #
7 /
TYPE OF WORK
jt New Home
❑ Deck
❑ Re -Roof
❑ Commercial 9 Residential
❑ Addition
❑ Fence Height:
❑ Re -Side
EST. VALUATION OF WORK
❑ Remodel
❑ Pool
❑ Ret. Wall Height:
$ 006--
❑ Finish Basement
❑ Stucco Demo
❑ Window Replacement
Building Height: o ' Feet
❑ Accessory Structure
❑ Stucco
❑ Other:
# of Stories: '
SCOPE OF WORK:
4e/C
Use of Building: 19.9f. depwoj
Signature of this application by the legal property owner or a licensed contractor, as the owner's representative is required and authorizes the City Zoning Administrator or designee and the City 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, specifications and conditions and to abide by all ordinances of the City 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 with 180 days from date of permit issued. or if building and
work is suspended, abandoned or not inspected for 180 days. work beyond or without a permit or inspection will be subject to a penalty.
Call MNSPECT for inspections at (952) 442-7520. (24 Hour Notice) 5:00 a.m. - 4:30 p.m.
SIGNATURE OF APPLICANT:
DATE: d
PRINTED NAME: ,i45
I DATE: -1 f td
E ONLY BELOW MI
LEGAL DESCRIPTION: Lot Block Addition Zoning
Valuation of Permit: _
Lot Area: 0 o S
OCCUP. TYPE: �—CONST. TYPE: I%� CODE:
BLDG SPRINKLED
Yes _ No
SETBACKS: REQUIRED (ft)
ACTUAL (ft)
NOTE: The applicant is
required to submit commercial
plans to Met Council
Environmental Services for
Sewer Availability Charge
(SAC) determination. Contact
Jessica Nye @ 651-602-1378
for submittal requirements.
Permit will not be issued until
a determination letter is
provided.
TOTAL DUE:
Permit Fee:$
Front (ROW) Sh
_
Plan Check Fee:$ / 10Q
Rear
fe Side 101
Corner
State Surcharge:$ ZOO, e)0
Site Insp. Fee:$ .00S
SEMA Fee:$
S.E.0 Fee: $ ZLC) - 00
Lakeshore
SAC Charge:$
Wetland
wac Charge:$
_
Other
Sewer Hook -Up:$
Water Hook -Up:$
Water Meter:$
Paid
Receipt No.
�,� 8r.1 then:
Is 5--
_
Date
lBy
BUILDING APPROVAL BY:
DATE:-��
CITY APPROVAL BY:
DATE:TIME:
All new construction and/or dwelling expansion shall require a certified survey dated within five years of application.
All new construction and/or dwelling expansion will be subject to contracted planner review and may add to the application time
period, somewhat.
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