HomeMy WebLinkAboutPermit 3065B11
APPLICATION FOR BUILDING PERMIT
SCOTT COUNTY, MINNESOTA
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(50,~
-CO'NTYUSEONLY~
Project Address 11/ 13'~ Chc(€_
Post Office City {-/rlor L 0./4- 7ip 553'7,;;1,
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jDt,S-e-l/
Permit number
Receipt number (163:;--
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AP~L\CANT FILL OUT INFORMATION BELOW:
Applicant 15u~...sv, II-e- tf~l~~Phone(Home)
Address /o'{'f!t/ RAod(J- J:s/. ity S/L(){JfJ~tate
Owner(ifotherthanApplicant) ~A-r.:_~ h-Cl/n k- PhOne(HOme)
Add res" J 7/73 :r:da Cv. Cityrh orW''&tate fYMJ
Contractor Name - ~~U} lie. /.k;,l1 ~
City
/lJfY'Jork)M4- tJOO~
m Zip ~.3'7r
Address
Phone (Home)
State
(Work)
Zip
(Work)
Zip,
..ss 3'l~
Project Legal Desc Parcel No. No. acres
Se" J 0 Lot Block _ Subdivision Name _
The above applicant applies fora permitto: R e:it>/tlC;,Jl,.,/ ...(Mrna C~
I (erect, construct, enlarge, alter, repair, move, Improve, remove or convert as case may T1 J
Type of construction: Wood Masonry_Other _ Type of heating system 1-1> G- tt-S F/ A
, ,
Dimensions of structure
Estimated cost orvalue Numberof Bedrooms
NOTE: A survey Is required by a registered surveyor for all new home applications on less than 10 acres.
If a survey is not required, a Plot Plan must be submitted, Please contactthe Building Department for acomplete 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 for its permitted~
~""." """"" /16 fl'1-3
~~~TOWNSHIPORCITYUSEONLY~~
Recommend Approval
Recommend Disapproval
Rubject to the following conditions:
Signature of Township or City Clerk (or representative) Date
~COUNTYORCITYPLANNINGUSEONLY~~
Minimum setbacks: Road
Approved Denied
following conditions:
Signature Planning)
Signature (Environmental Health)
Sid" Rear Lake/Creek/Wetland :Zoning district
By Planning/Environmental Health, subject to existing regulations and the
Date
Date
~~~~ COUNTY BUILDING USE ONLY ~~~~
Approved K Denied By Building Official SUbject to existing regulations and the following condltio~
//1/7/,4< ( -z:;.:, C oLJ&c - A/C:;/E// O1!-7d-7 'FEY '7 ~
SI~nature /' ~ _ ~......-=t - Date /~) h ~J
Additional
FEES: Land Use Permit
Sewer Installation Permit
Plumbing Permit
State Surcharge
Building Permit
Plan Check
,50
3DOD
TOTAL FEE
3DSD
White-County Yellow-Township Pink-Applicant Gold-Township
06600-2805 (6-90 1 M)
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COUNTY OF SCOTT
INSPECTION NOTICE DA E
PERMIT NO. 3o~ -.8~/1 SCHEDULEDtlii}~
TOWNSHIPfiOl!I=f ~I ~ COMPLETED Y-2/~
ADDRESS F}/ 'J f3 J-dA (liJ-u fL?
OWNER
CONTRACTOR:
PHONE: 496-8334 or 496-8475
TIME
/:CO
/.i"()CJ
o PLUMBING RI.
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL.
o SEPTIC MAINT.
o SEPTIC FINAL
o PLUMBING FINAL
o
FUI'0VAcC
o SITE IN5PECTlON
o EXCAVAnNG/GRADtNGIFILUNG
o LAKESHORElWETLANDS
o COMPLAINT
o FOLLOW-UP
o FlREPLACElCHIMNEY ntROAT
o F1REPLACEfCHIMNEY FINAL
o GAS UNE PRESSURE
o
/~~7/tJ"-
o FooTlNG
o FRAMING
o INSULAnO~
o WALL BD.
FINAL
~ PROGRESS
o DEMOL.
o FIRE PREVo
o
COMMENTS:
01<:
tX WORK SATISFACTORY: PROCEED
~ ='tORRECT WORK' PROCEED
=- CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
=- CORRECT UNSAFE CONDITION WITHIN ~ HQURS. INSPECTOR WILL RETURN
=- STOP WORK ORDER POSTED. CAll INSPECTOR
=- INSPECTION REQUIRED. CALL TO ARRANGE ACCESS
C PHOTO T....KEN
BUILDING INSPECTION OFFICE
Courthouse A102, 428 S, Holmes 51., Shakopee, MN 55379
Call for the(Jinspection 24 hours in advance
Owner/Contr. on site
\
Inspector A.l..ur l-r AJtF
06600-2807(10-94 4M)
White Copyllnspector's File Canary Copy/Records Pink Copy/Sne