HomeMy WebLinkAboutPermit 1424B12
\-i)) 'Syry^\I:f~C9 LAN~
C~\~'\'\I'i\%:~~
~ TOWtilsHIP SCOTT COUNTY, MINNESOTA
Owner: Name:~~i')--I!,{) ~JQ l)-~.
Address= {L U \.\ ~ ::.:N.I.1. .
APPLICATION FOR BUILDING PERMIT
, l\.d. '\>~) d--
PERMIT NUMBER
- w.,__..__~m ". ._... Phone: 'llj.,:l, :j';;..Wc
V~/\,'~ ~ I~ - . _____
"
Applicant (If other than owner) Name:
Addres~'
The above applicant applies for a permit to_~"-0.~C
(~ ()C'\ .:.,n ''\ ,"
'~ '.,
Phone:__
''\ (.. It ':;'~ ()
(Build, altef, repair, wreck. as case may bel
PERMITS APPLIED FOR: (Check those applicable) BUILDING (Estimated Cost) -t GtR:l
WELL: ._.__nn___
KIND OF CONSTRUCTlON:".___._____
Number of Bedrooms'
Legal Description of Property: \J l0( \\,
Township: \\\..\ Section:.l\.__ Rang~...d:-___ or Lot__ Block:
Zoning District Agricultural: Residential: Commercial:
A Plot Plan showing the following must accompany this application:
1. North Direction 5. Street name or road number
2. Location of Proposed 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 s(iificatio, ns, herewith submitted and with the ordinances, of Said
Township and County applicable thereto. I At '_ j' 'I' I 2 / r:--
~L. ')"f'-/> ~ f ../. ~ .L!.L!..d --r U__
Applicant's Slgn.ture Dale
General Contractor:
Subdivision:_____
I nd ustrial: ___ __no_.
TOWNSHIP USE ONL"
Recommend Approval: ___k
subject to the following conditions:
Reasons for disapproval'
SIGNATURE OF TOWN CLERK: (Or representative~ ~ f'~" (
COUNTY USE ONLY
By Zoning Administrator subject to existing regulations and the following
_..... ~~ ~_~ \1",:"'.. . .#111- iJ~l&-
I ,
Recommend Disapproval:
Approval recommended
LV &\tLl ~!.JJ1DATE: \\" \=>...~x (',
iJ -
SIGNATURF'
~/ _ Denied:
-2'" .L
~L.Y'-1.
\
~~
DATE:_J.I.=1;- go
Approved:
conditions:
Approved:
conditions:
Signature:
{/'
Denied:
COUNTY USE ONLY
B, B';";~r;7:?;~9Mg:~:7~~';~o.;"g
FEES:
Zoning Permit
Sewer Installation Permit
C
Receipt# 046 \
Plumbing Permit
Well Permit
Plan Check
'''<,. "r)
r n Oc~1"">
~.~-
.b_.___
State Surcharge
Building Permit
TOTAL FEE
(]~_' ,82 ~;
1. County Copy (White) 2. Township Copy (Canary) 3. Applicant's Copy (Pink)
Form No.1
Revised 8-1-80
No. 294__ _ _ ._ _ ._. Miller-Dnis Co..M:ianea U.
~ ~t'''''::--;''''~r~'f-':~':::;''''~t;'''-~'~-'''''tf''''-:=~-':~~JofilI::~~;~~tiJ1t-:-'''''.ti31-"'~~~t_']t'" 11' ""f:>' ~
, 14.25
I ~tatt of :JMinnt~ota:,
County 0/ Scott
no.
1..2......12
13th Itl lIoveab.... 1180
8uIM.fnl
Offici of Buildin& Official
~ermit
IN CONSIDERA nON OF The statements made by r~... R..~..
_Gute .. Box 244, Prior Lake. JIIC li1.ll111
jn application therefor duly :filed in this office, which application is hereby made a part hereof,
PERMISSION IS HEREBY GRANTED To said Juell Sexe ., owner,
build ll. ll.arage
t"
upon that tract of land described as follows: Lor
Add...... .... k '.9tlor "
! which tract is of the size and area specified in said application.
'This permit is granted upon the express conditions that said owner and a...... contractors, agents, "
workers and employees, shall comply in all respects with the ordinances of the.............................................. "
. oqll~ of_joot:t . ,
, Given under the hand of th" Building Official "f saiA oounty md its corporate '
seal an~=ted-fbY ir- Plannin(i DireOlOr ..1Ji. 13t!l /"0 ;:vetllbe~j-~ , 19 10 I
( . . I,) 1J4,7t;. Lr., (!L-- /7/ /;./z;;7
\. Planning Director v Buildina Offioial
~locl-
; plat or additiOD-.
""~ ...~
'''-..'.~~---,..~'
t4...JI ~!~.~J... ~t~- W ~~',-~~Ctt._.::.._.~:t~ .
~t~