HomeMy WebLinkAboutPermit 2275B11
APPLICATION FOR BUILDING PERMIT
SCOTT COUNTY, MINNESOTA
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PERMIT NUMBER
17cJc;J:;(
RECEIPT NUMBER
Spring Lake
TOWNSHIP or CITY
PROJECT ADDRESS: 17025 MUshtown Road. Prior Lake. 55372
-i'~ j.,
APPLICANT NAME: ~ Louis 1. Stassen
ADDRESS: 16617 Creekside Circle, Prior Lake
OWNER (If other than Applicant): .bmes A. SPXP
ADDRESS: See above
CONTRACTOR NAMF'
ADDRESS:
Stassen Builders
See above
HOME PHONF' 447-2275
WORK PHONF'
HOME PHONE~7--:;Rh?
WORK PHONF'
PHONE: 447-2275
The abOve applicant applies fora permitto: Replace livi.l'li' r."(1I11 wino"'.' pvtp')Q t'"hlp f'T)r1 "f roof north
(Build, alter, repair, move, install,as case may be) and west side.
TYPE OF CONSTRUCTION: Wood_Masonry_Other_ TYPE OF HEATING SYSTEM:
DIMENSIONS OF STRUCTURE:
ESTIMATED COST OR VALUE: t '-/ 310 NUMBER OF POTENTIAL BEDROOMS'
. ~ II
LEGAL DESCRIPTION OF PROPERTY' N (;.)/; ~ (JOn J '/ Lo r '!
SECTION: 11 LOT: BLOCK' SUBDIVISION NAME:
NUMBER OF ACRES' Citv lot TAX PARCEL NUMBER: II-CII/03 d-.--CJ ZONING DISTRICT: IlF.
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 01 PrOposed 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 be used comply with the
plans and specifications herewith submitted and with the Ordinances of ~ShiP and coun... . abl,hereto.
// ~J
V A lIcant's g ture
7, Location and size of Septic Tank and Orainfleld,
8. Location of well.
7-27-88
Date
Recommend Approval: X Recommend Disapproval:
subject to the following conditions: g ~ - ,
SIGNATURE OF TOWN CLERK: (Or representativ hA J),L Cl'Adl' ~A1.JN'~
COUNTY USE ONLY"
DATE' 7-27-88
Approved: DBnied'
minimum setbacks from: Road
By Zoning Administrator subject to existing regulations and the following
Side Rear with the following conditions:
SIGNATURf'
DATF'
COUNTY USE ONLY
Approved: Y Denied: By Building Official subject to existing regulations and the following conditions:
..4 L, C ./0 .4 '7 6r-z..r 4C ---4 --.....- b7 L-.4 0" a 7" ~ ~7 <="- r=T c:.oO cf'-
~ ~~~ - DATE: ;;?/~~~
SIGNATURf'
.... ---
ADDITIO~OMMENTS:
FEES: Land Use Permit
Sewer Installation Permit
Plumbing Permit
Well Permit
State Surcharge d,StJ
Building Permit 5 <j, 7;)
Plan Check ,~b,S7
Fireplace/Wood Burning
APpliance
TOTAL FEE 91.79
011IOO-2805
Revised 6.85
1.lnl" ." Copy (While) 2. TO_""pCopy(Can8lY) 3. AppIlcMt'ICopy(Plnk)