HomeMy WebLinkAboutPermit 4267B11
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APPLICATION FOR BUILDING PERMIT
SCOTT COUNTY, MINNESOTA
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Project Address
Post 011 ice City
/70;z.5
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Permit number'--/. ')..6 ?-J-II
Receipt number -17 7~7
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___ APPLICANT FILL OUT INFORMATION BELOW: LJY ~6 a
Applicant .J I ~ S ex e- ~J...... Phone (Home) ~ - (Work)
Address )7l!J:J.slfvdJDW.,} p,. cL CityP. J..P-~, State H" Zip ,r,r,7".{
Owner (if other than Applicant) .5" 14 G Phone (Home) (Work)
Address City State Zip
Contractor Name
Address
State Contractor's License Number
:5 -? ).,L
City
Phone (Home)
State
(Work)
Zip
Project Legal Desc,
secL Lot Block _ Subdivision Name
The above applicant applies for a permit to:QvJ j. f:/ De ck;.
(erect. construc!. enlarge, alter, repair, move. improve. remove or convert as case may be)
Type of construction: Wood V- Masonry_Other _ Type of heating system
Dimensions of structure .!l ~ 'X) J:, I
e. ~ 11,8 o-lI, ~
Parcel No.//9 II ~ ~'^O
No, Acres
..50
USE"
(house,g~Mk.reroo',etC)
/
Estimated cost or value
Numberof Bedrooml
.
N/6- ________
,
NOTE: A survay Is required by a registered surveyor lor all new home applications on lesl thin 10 acres.
tl a survey is not required, a Plot Plan must be submitted. Please contact the Building Department lor a complete list
of items required for permit approval.
Applicant hereby agrees that, upon issuance of this permit, all work shall be done and all materials used shall be In
compliance with any applicable township, city and county ordinances, The applicant agrees to abide by all zoning
regulations, and utilize this structure fO:;;v;~~s.e'J//Y.L 1 ~;?~ ~'1 CJ
Applicant's Signa{ure Date
~ rL~~TOWNSHIPORCITYUSEONLY ~~
Recommend Appr ~ / Recommend DisaJ:pproval . ~ubjectlo the following conditions:
Signature of Township or City Clerk (orrepresentativ " ~- Date7-;g~ -9"
~~COUNTYOR PLANNINGUSEONLY~~
Minimum setbacks: Road Side,
Approved I ~enied
following conditions:
Signature Planning) ~~/..:
Slgnature(Environmental Health)
Rear I akelCreekJWellar1d 70nlng district
By Planning/Environmental Health, subject to existing regulations and the
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Date
Date
7-2 z -7?
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~~COUNTYBUILDINGUSEONLY~~~
App_ 4jp~;P;~-Ty:BYBUlldi~~~;:~;:PWtiO and the 101:01'!in <::::> I~~
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Signature ,"''''''l'f''W'' '----.-/ Date" ~"A"A'-'i
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Additional Comments:
d&u6/e-.
p.e.-e.---
FEES: Land Use Permit
Sewer Installation Permit
Plumbing Permit
Plbg./Mech, State Surcharge
Bldg, State Surcharge
Building Permit
Plan Check
Erosion Control
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/ ~". 0 0
"/1),9S
TOTAL FEE
//;,3(,/
06600-2805 nQ-961M)
White.County Yellow. Township Pink.Applicant Gold. Township
COUNTY OF SCOTT
INSPECTION NOTICE
04267 B 11
PERMIT NO_
TOWNSHIP/CITY
SL I
SCHEDULED
rOMPLETED
PHONE: 952.496.8475
DATE_/_I_ TIME:
2004/07/02 14:00
ADDRESS
OWNER,
17025 MUSHTOWN RD
9-..a~ AA~ 7::'71
rONTRACTOR
~EVIN STOCKE
TYPE OF INSPECTION
COMMENTS:
:;'::: r:.\~ Dr:-G:,
,j
/
~k Satisfactory: Proceed
o Correct Work Call for Reinspection before converting
o Correct Unsafe Condition within _Hours Inspector will Return
o Correct Work & Proceed
o Stop Work Order Posted Call Inspector
o Inspection Required Call to Arrange Access
BUILDING INSPECTION OFFICE: 200 Fourth Avenue West, Shakopee, MN 55379-1220
Owner/Contr. on sitf'
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1\ (a1y\ -<
Call for the next inspection 24 hours in advance
,;--, ^. ,t.. /;> Inspector