HomeMy WebLinkAboutPermit 1568B12
"y_~ t~ APPLICATION FOR BUILDING PERMIT \ ~:';lrI< ' R -. J;}.
-~OW~~lh, . SCO!! ~OUNTY, MINNESOTA PERMIT N,UMBERI-
Owner: Namp' ,-;G/.J2~~ . e...1//~ ;J~ ~" 11. . Phone: 4'1/'-41 It.
Address: /7/10 f ~..J[~ Lt~:W.u,-~ ,_~~_~_ <.,.-s /:.2-
Applicant: (If other than owner) Namp' ~:/~
Address' A~
The above applicant applies for a permit to C;",4;.~'f ';/- '" ~ la ~.;J.. g
Ph'ilne: ,
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(Build, alter, fepair, wreck. as case may be)
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PERMITS APPLIED FOR: (Check those applicable) BUILDING (Estimated Cost)
KIND OF CONSTRUCTION:
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fl. ,._.-J!,
Wr::II'
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Numberof Bedrooms' , General Contractor:~ ~JI'
Legal Description of property: fIJ E Y.J ,
Township: fIe..!; Section: /6 Range: ~.J.....ol)..ot: d... Block: \ SUbdivision:~~'
Zoning District: Agricultural: Residential: t--' Commercial: Industrial:
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 Drainfleld
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 ,~eci,fic7ti n~erewJ,'t~>>.'bmitted and with the ordinance, s of Said
Township and County applicable thereto. Jf..~Iw-~ f. 'f(;L.'-.-/d 7 ~d...lr ?;J--
. Applicant's Slgn.tur~ ; - Date
/' TOWNSHIP USE ONL"
Recommend Approval: V ~. R~Fqmmend Disapp~al:. , tpprova) reco~ended
subject to the following conditions: }[)/o-U jlJlQ ~ c.!'" -,!,) o....L ,~L__ fu J ( ~
Reasons for disapproval: i , ," ' - ~
SIGNATURE OF TOWN CLERK: (orrepresentatiVe).J..L!..U'VJH Q;::]{~ nATE: 1}~:;..lr fJ
, COUNTY USE ONL'.
,/ Denied: By Zoning Administrator subject to existing regulations and the following
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Approved:
conditions:
SIGNATURF'
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"ATr::. 7- 30- Jb
Approved: ,/ .Denied:
conditions:-tA ,(l.,.,..,,\". c' ./..
Signature: (')
"'OUNTY USE ONL"
BYptUildi 9!!icial subject to e~iStin9 re ulations and the following
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FEES:
Zoning Permit
Sewer Installation Permit
Receipt # ql '-,u
Plumbing Permit
Well Permit
Building Permit
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'tB .(')lJ
State Surcharge
Plan Check
TOTAL FEE
<2 -: r:;- D
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1. County Copy (White) 2. Township Copy (Canary) 3. Applicant's Copy (Pink)
Form No.1
Revised 8-1-80
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COUNTY OF SCOTT
INSPECTIO..N NOTICE CALLED.IN
PERMIT No.a\=,K~ SCHEDULED
TOWNSHIP/CIT'f~R ,COMPLETED
ADDRESS nllQ q \~ f;. t;\, C uA .St
OWNERRf,.,..\..i'\~() <r O~oM.\l,
CONTRACTOR: Sl"'I-1=-'-O
o FOOTING rl PLUMBING RI
o FAAMING (fr( 0 MECHANICAL
o INSULATION 0 WATER HOOKUP
o WALL BO.
'A-FINAL 0 SEWER HOOKUP
o PROGAESS n SEPTIC INSTALL.
o DEMOL. 0 SEPTIC MAl NT.
o FIRE PREVo 0 PLUMBING FINAL
COMMENTS:~U\,.( f\,v:JVO\')(~ "Of~N"
L..." X.\(,\" :t'nl ~ I ("IiO,J. '
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DATE
TIME
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PHONE:
o SITE INSPECTION
o EXCAVATING/GRADING/FILLING
o lAKESHQRElWETLANDS
o COMPLAINT
o FOLLOW-UP
o SEPTIC FINAL
o
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ACTORY: PROCEED 0 PHOTO TAKEN /
o CORReCT AK & PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
o CORRECT UNSAFE CONDITION WITHIN HOURS. INSPECTOR WILL RETURN.
o STOP ORDER POSTED. CAll INSPECTOR.
o INSPECTION REQUIRED, CALL TO ARRANGE ACCESS.
OFFICE OF PLANNING, INSPECTIONS AND ENVIRONMENTAL HEALTH - 445-mO, oxt, 353
II the next Inspec~ hours In~nce
nerIC .onalte .1-/\( \/1 E
tor D ~.., \1
06608-2807 ,/ Whitt Copy/In..'. FIIo Canary Copy/Rocarda Pink CopylSItt