HomeMy WebLinkAboutPermit 3962B11
Townshlp/6Ity-
.s:L
- COUNTY USE ONLY ~
APr 'CATION FOR BUILDING PE' ~IT
SCOTT COUNTY, MINNESOTA
""'-~~~~
Project Address
Post Office City
/'1Dl..t..fl
f'Y\-6--,~ 1-<.
7ip
/.....""
Permit number 3cU,:;t- g-I \
Receipt number I 4- "11 1
~~~~-~~~~~~~-
A
APPLICANT FILL OUT INFORMATION BELOW: ri./
Applicant ~~///// / /U/~~r/"n.-, _ Phone (HOme~/";'h~WOrk)
Address /76<//) fi..~ple )./').City~.nL~tate /~~ Zip s~n..2--
Owner (if other than Applicant) Phone (Home) (Work)
Address City State Zip
Contractor Name Phone (Home) (Work)
Address City State Zip
State Contractor's License Number
Project Legal Desc.
Parcel No.
No. Acres
Sec Lot Block _ Subdivision Name
The above applicant applies for a permit to: {" c: - f" 0 <:>~ in... ~ (I ',,\0'
(erect. construct. enlarge. aller. repair. move. improve, remove or convert as case may be)
(house, garage, deck, rerool,etc.)
Type of construction: Wood
Dimensions of structure
Estimated cost oryalue
Masonry_Other _ Typeofheatingsystem
-:J_ 'I f:.1i ,----" .,.. "--
J 4 I!: ~.c!U NumberofBedrooml
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 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, for ,i,ts p~~ted use. ~ /
~L~ ~::.....>
y./~-~~ ~ _~~ . ~9 ~',rh'f
~ ./ Applican Ignatt'fre. D .- .-
~TOWNSHIPORCITYUSEONLY_~
Recommend Approval
Recommend Disapproval
subject to the following conditions:
Signature of Township or City Clerk (or representative)
Date
~~COUNTYORCITYPLANNINGUSEONLY~~
Minimum setbacks: Road
Approved Denied
following conditions'
Signature Planning)
Slgnature(Environmental Health)
!'>ide Rear Lake/CreeklWetlMd "Zoning district
By Planning/Environmental Health, subject to existing regulations and the
Date
Date
"'-""""~_ COUNTY BUILDING USE ONLY ~
~ Denied By Building Official subject to existing regulations and the following conditions:
;dLt.- '-~t-
Signature .(1J?NK VVDt-P
,
Approved
111 A 7c.L1 AI,
'-To
~oU'/('
<;z;,;:r r_ol) c.
Date ?-(-qg
~~~~~
~~~~
Additional Comments:
FEES: Land Use Permit
Sewer Installation Permit
Plumbing Permit
Plbg./Mech. State Surcharge
Bldg. State Surcharge
Building Permit
Plan Check
I . /R)
2S'.~
:>;:)~
Erosion Control
TOTAL FEE
~~.'l~
06600-2805(10-961M)
White.County Yellow-Township Pink-Applicant Gold-Township
COUNTY OF SCOTT
INSPECTION NOTICE
PERMIT NO. ::s q;/,~-~-I/ SCHEDULEn
TOWNSHIP/CITY $,L. - COMPLETED g-L-9:9' 2.')6
I 76'-1 0, V"Vb.D I:c
~~)
PHONE: 496-8334 or 496-8475
DATE TIME
ADDRESS
OWNER
CONTRACTOR'
1.Y1.
;:.
>-
'"
u.
<(
V)
Cl
'"
<(
1:
>-
-'
<(
'"
1:
-'
<(
'"
o
V)
0:
'"
"-
0:
'"
o
>.
0:
o
U.
'"
0:
<(
V)
>-
'"
'"
::;;
'"
0:
:;
o
'"
0:
'"
Cl
Cl
"
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o WAll 80
o FINAL
e PROGRESS
o DEMOl
o FIRE PAEV
o SITe tNSPECTION
o EXCAVATINGiGAADINGfFllllNG
o LAKESHQRE/WETlANOS
o COMPLAINT
o FOLLOW-UP
o FIREPLACE/CHIMNEY THROAT
o FIREPLACE/CHIMNEY FINAL
o GAS LINE PRESSURE
o
o PLUMBING AI
o MECHANICAL
a WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTAll
o SEPTIC MAINT
o SEPTIC FINAL
e PLUMBING FINAL
~
COMMENTS:
K'Li II>->,"",.{.l
/h' //lei l
-nJL
PROJECT COMPLETION DATF
o WORK SATISFACTORY: PROCEED 0 PHOTO TAKEN
o CORRECT WORK & PROCEED
o CORRECT WORK. CALL FOR REINSPECTlON BEFORE COVERING
o CORRECT UNSAFE CONDITION WITHIN HOURS INSPECTOR Will RETURN
o STOP WORK ORDER POSTED CALL INSPECTOR
o INSPECTION REQUIRED CAll TO ARRANGE ACCESS
BUILDING INSPECTION OFFICE
Courthouse A102. 428 5, Holmes St.. Shakopee. MN 55379
Call tor the next inspecll~24 hpurs if adyance
Owner/CoRtr. on site ~ \-b~,
Inspector Y;::" -.L.. (' rJ;? -
. - '--"
06600-2807 (6-975M)
White Copy/Inspector's File Canary Copy/Records Pink Copy/Site