HomeMy WebLinkAboutPermit 2021B12
APPLICATION FOR BUILDING PERMIT
SCOTT COUNTY, MINNESOTA
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PERMIT NUMBER
1"/357
RECEIPT NUMBER
Spring Lake
TOWNSHIP or CITY
PROJECT ADDRESS:
APPLICANT NAME:
ADDRESS:
17121 Mushtown Road. Prior Lake
Wayne D. Liebhard
17121 Mushtown Road,
Prior Lake
HOME PHONF- 447-1854
WORK PHONE' 445-64L.O
HOME PHONF'
WORK PHONF-
PHONE: 447- 1285
OWNER (If other than Applicant):
ADDRESS:
CONTRACTOR NAME"
ADDRESS:
Bruce Gerdes
Prinr l~kp_ M;nnp~nt~
The above applicant applies fora permit to: Install a fireplace and chirrmey (zero clearance)
(Build, alter, repair, move. install, as case may be)
TYPE OF CONSTRUCTION: Wood_Masonry--K-Other_ TYPE OF HEATING SYSTEM:
DIMENSIONS OF STRUCTURE:
ESTIMATED COST OR VALUE'
LEGAL DESCRIPTION OF PROPERTY:
SECTION- 12 LOT' 1 BLOCK-
~~
NUMBER OF POTENTIAL BEDROOMS-
SUBDIVISION NAME: O'Rourke Addition
NUMBER OF ACRES: Citv lot TAX PARCEL NUMBER- 70NING DISTRICT: R-2
NOTE: A SURVEY IS REQUIRED BY A REGISTERED SURVEYOR FOR ALL NEW HOME APPLICATIONS on 10 ACRES or LESS.
A Plot Plan showing the fOllowing must accompany this application:
1. North Direction. 4. Dimension of structure(s).
2. Location of Propose<J Structure on lot. 5. Street name or road number.
3. Dimensions of front and side. set back. 6. Locations of existing structures.
Applicant hereby agrees that, in case above permit Is granted, that all work shall be done and all materials ,which shall
plana and specifications herewith submitted and with the Ordinances of Said Tow~s~l~nd County Appll Ie 10.
W t! . 0
Applicant's signatu;^J
7. Locetlon and size of Saptlc Tank and Dralnfleld.
8. Location of well.
ply with the
10-22-86
Date
TOWNSHIP USE ONLY
Recommend Approval: _ X Recommend Disapproval:
sUbject to the following conditions: Must meet count.v code Q. / 9 /
SIGNATURE OF TOWN CLERK: (orrepresentaliv~aldUJI' ~p V~) DATE' 10-22-86
COUNTY USE ONLY, (.
Approved: Denied' By Zoning Administrator subject to existing regulations and the fOllowing
minimum setbacks from: Roarl Sid" Rear with the fOllowing condillons:
SIGNATURE'
DATF'
COUNTY USE ONLY,
Approved: ~ Oenie(l- By Building Official SUbject to existing regulations and the following conditions:
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SIGNATURE: C'~ 7!- 9/~ DATE:/O-;l.'?-j'6
ADDITIONAL COMMENTS:
FEES: Land Use Permit
Sewer Installation Permit
Plumbing Permit
Well Permit
State Surcharge
Building Permit
Plan Check
Fireplace/Wood Burning
Appliance
TOTAL FEE
150
/scHJ
iK.SD
_2805
Revised 6-85
I. Inapector'a Copy (White) 2. TOMIaIlIp Copy (CanlllYl 3. AppIIc:8nt'a Copy (Plnkl
COUNTY OF SCOTT DATE
INSPECTION NOTICE.. CALLED.IN
PERMIT NO. ::loi9.I-6-J~ SCHEDULED . '~4
TOWNSHIP/ClIiI=P sL COMPLETED l/-/2-fJl."
ADDRESS / 7/~ I '-;;7k~/.n4, .~./
OWNER~ ~~4f . PHONE:
CONTRACTOR:
TIME
/;:T
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o FOOTING
o FRAMING
o INSULATION
o WALL BD.
o FINAL
o PROGRESS
o DEMOL.
o FIRE PREV.
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SITE INSPECTION
o EXCAVATINGfGRADINGlFILlING
o LAKESHQRElWETLANOS
o COMPLAINT
o FOLL~W'
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Q COMMENTS:
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o SEWER HOOKUP
o SEPTIC INSTALL.
o SEPTIC MAIHT.
o PLUMBING FINAL
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o WQRKSATISFACTQRY: PROCEED 0 PHOTO TAKEN
o CORRECT WORK & PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
o CORRECT UNSAFE CONDITION WITHIN HOURS. INSPECTOR WILL RETURN.
o STOP ORDER POSTED. CAllIN$PECTOR.
o INSPECTION REQUIRED. CALL TO ARRANGE ACCESS.
OFFICE OF PLANNING, INSPECTIONS ANO ENVIRONMENTAL HEALTH - 445-mo. ext. 353
Call for the next Inspection
Owner/con~
Inspector ...., j7l.-u-
06600.2807 White Copy/Inspector's Ale
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Canary Copy/Record.
Pink Copy/Site