HomeMy WebLinkAboutPermit 1583B12
.
R()6.j ~-~'A-> ..........,
a \j) NJ'--/"\ 11 \ ~ l f ~v\G\ \"f\ (I.. Cl \J
< c1al!u- APPLICATION FOR BUILDING PERMIT I~ 2>- R-&
Owner: Namp' ~ "'r" I. .. l... ~ \ .p'hone:!-/!i1 3 if 3 ;:;..-
AddresL'7?c:2! u)~. /:?6 _~~., rYl..A:-- :~fS37f'
Applicant: (If other than owner) Nam'" Y..-- ~
Addrp.QQ' ~. Phone:
The above applicant applies for a permit In ('~ h.Lt~) ~
(Build, alter, r.palr, wreck. n ca.e may be)
t-/S a7J ~
. /
PERMITS APPLIED FOR: (Check those applicable) BUILDING (Estimated Cost)
4((
/J~ fA~I~
.a...
KIND OF CONSTRUCTION'
Number of Bedrooms'
Legal Description o~ Property: IJ (.J Y.j
Township: 1/ tf Section: I ( Range:::L .,..... or Lot: is- Block:
Zoning District: A~ricultural: Residential: _1< -:2- Commercial:
A Plot Plan showing the following must accompany this application:
1. North Direction 5. Street name or road number
2. Location of Proposea Structure on lot 6. Locations of existing structures
3. Dimensions of front and side set-back 7. Location and size of Septic Tank and Drainfield
4. Dimension of structure(s) 8. Location of Well. Distance from Septic Tank and Drainfield
Applicant hereby agrees that, in case above permit is granted, that all work shall be done and all materials which
shall be used shall comply with the plans and specifications herewith submitted and with the Ordinances of Said
Township and County applicable thereto. ~ /2~27 9- /I~ <g':J-
, APPIIC~-;gn.tur. " Date
r,eneraIContractor:~ ~~
SUbdivision~~
Industrial'
Recommend Approval:
subject to the following conditions'
Reasons for disapproval' )'
SIGNATURE OF TOWN CLERK: (Or representative) V. j'JPAn fJ ~
~
TOWNSHIP USE ONLY
Recommend Disapproval: .
Approval recommended
DA TE:.3 -11- 3:f,
COUNTY USE ONL'
APpr~~ed:---f.,//! Denied: By Zoning Ad~inistrator Subje~ t~ existing regulations and the following
conditions: ,J_ >/'v..- ~~ .~~ . ". .-e'o/ Vt'~
, . - I ''''''- ~ - / I "
SIGNATURI" ,j,.,r~ Lt!7'" rQ ~- I")ATE:_"J-//~--ZZ-
COUNTY USE ONLY
v
Denied:
By B~ /3lcial subject t:~~ting regulations and the following
(rdJ;, . .1ft/ ~ DATL9-/'/-,f$-..
Approved:
conditions:
Signature:
FEES: Zoning Permit
Well Permit
Sewer Installation Permit 4D.(X)
44 .:\()
_L:; .lJ0
-;:n ,co
(;}/ (If) .9"'J
1.30. (]S
Recelpt# q q 03
-~ ,\-2./UJ'f~~
. - \ \\)~"-:\
'-/'--. -' '--,
Plumbing Permit
~~~
'S~
State Surcharge
Building Permit
Plan Check
TOTAL FEE
,~(l,) . lC:;--
Form No.1
Revised 8-1-80
1. County Copy (White) 2. Township Copy (Canary) 3. Applicant's Copy (Pink)
No. 294 Miller_Davis Co., Minne;;f'oh"
~"'';!___-l1-<'''_~''i!lli!m!'..U''9!i'-_&iO''
\ $nHH.~~75un nO.J~.~~.IH~uuuu......1
~ i:>t~tt of s~~nnt5ota. } ..~uJ~~~mofn.~,,~~r:!.n~!l!l~.u.u..uu.... '
~ County 0,. m 'nUm.. Unmn...U....m.. mn Office ofu.BII~ldtng..OfffCfA-l.....u...umuu__
,I ..uuuUnU u.~~.il.~.~.~~.uu.permlt
~. IN c.ONSm!,RA;r.tIO~ Of The st...~.ments made by n.uuR()~~r:L~~.!!H,Luu .....um.m.m.m.n"u'm
NJ 7721tcv" D) :h3t. vavitqe, !'4lIl
__U" . _n___uu'_ __ ____u.__________n. _______u__._ ___ ___ ___._ _____ _ ___ a_________.____. _.______._0 ~u______.________________________u___________________________--____.
~ in.. 'm' num. application therefor duly filed in this office, which application is hereby made a part hereof, I
ill PERMISSb<JNdI~ I~:rrTht~~a~M~~ aIop~atdpTa~~~ii~~t~~t .u.....'UUmum mn as owner
~ to... ....mmu__m....__..n......Um...Um.u...u.m...mn. ..u.u....mu .UUm..uummuu....u..Umu.. 'um,.,,'n.. .um......m..
I !iL~~~~~;~:~f;~~;~:,~~~~~~~~.~5;~"~~~:==~];,:,,.,ddi,;~...."!<iel
fj This permit is granted upon the express conditions that said owner and his contractors, agents, .~
I workmen and employees, shall comply in all respects with the ordinances of the ;1
~ u.. .. .....mmu...m",,,,'m U ...m.mCgll!l'tYmoLnScQ.t1;.....m...mm .. u .. n n.uUn' ~
I. Given under the hatpia'h~.~h~ ~~n~.i. ~~nt:lf~fciai14tll. . of said~S:{{i!lIber and its corpor~e ..a
IJ seal and attested by s. muunT'u'.. uummthlsmm..mm day of.... .' ~ 191
l~~~~~~~~~~~~~~~.
---......:,..
~~
J
......i~~J"'~"~,~:_"~.,'..,'..,;.,.~O:'c..,;."..:~:.,"',.....~"'o,~."':".,.','.