HomeMy WebLinkAboutPermit 4703B11
APr' ~CATION FOR BUILDING PEp.~1T
T~p;/~ l.t.k.e. .;>COTT COUNTY, MINNESOTA
-COUN~USEONLY~
RECEIVED
SEP 2 7 2000
Project Address /7/::lJ /'t...aC ~
Post Oil ice City P"'.......~fl-
7ip s-rnL
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Permit number t..j 7CJ3-fi-/
Receipt number ~ / / '1 g
~
~~~~
Applicant
Address
APPLICANT FILL OUT INFORMATION BELOW:
Phone (Home) (Work)
Stale Zip
Phone (Home) '1'YO -'fl"il.t. (Work)
I'N.><-We State NP. Zip s)J'7~
Phone (Home) 'I'f7-Sc"'/ (Work)
City Prwr~.... Slate IYN. Zip S..- J7Z
Cily
w""'1....
City
Owner (if other than Applicant) LA..J<.. f &7/ ieo
Address /7/7}- H"{' i.. t....-...
Contractor Name 5~A<A. G9.....f:
Address 6 gar- 7}.,..d.\A !:1-~
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: r-e.s let....
(erect. construct, enlarge. alter, repair, move, improve. remove or convert as case may be)
usP' I.u......... to t:;~ e
- ... - ....
(house. garage, deck. reroof,elc.)
Type 01 construction: Wood
Dimensions 01 structure
Estimated cost or value
Masonry_Other _ Typeolheatingsystem
Numberof Bedroom.
NOTE: A survey Is required by a registered surveyor lor 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 its permitted use.
/2..JJ~
Applicant':ytignature
f"-:n -00
Date
~TOWNSHIPORCITYUSEONLY~~
Recommend Approval
Subject to following Conditions
Signature of Township or City Clerk (or representative)
Recommend Disapproval
Permit complies with the Wetland Conservation Act
Date
~COUNTYORCITYPLANNINGUSEONLY~~
Minimum setbacks: Road Side Rear Lake/Creek/Welland Zoning district
Approved Denied By Planning/Environmental Health, subject to existing regulations and the
following conditions'
Signature Planning) Date
Signature (Environmental Health) Date
::::~;n::f~c~:~~~:j~c~~oEe~i:t~~9::::=~
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Additional Comments: FEES: Land Use Permit
Sewer I nstallation Perm it
Plumbing Permit
PlbgJMech. State Surcharge
Bldg. State Surcharge
Building Permit
Plan Check
Erosion Control
,5"0
"7.5"',50
TOTAL FEE
"70 ,0{)
06600-2805(1Q-961MI
White. County Yellow. Township Pink.Appllcant Gold. Township
COUNTY OF SCOTT
INSPECTION NOTICE
04703
17125 MAPLE LN
363-2146
d/cIt'
final ".V ' :....'(<\
PERMIT NO
TOWNSHIP/CITY
ADDRESS
OWNER
TYPE OF INSPECTION
;OMMENTS:
SL
PHONE: 612.496-8334 OR 612-496-8475
Bll
DATE 6 { TIME:
ZV VI ~1 ~j:jU
16"-"'<=,6 .~ Z ~/"')CJ
SCHEDULED
COMPLETED
CONTRAClDR
SANDAHL
- ~
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o Work Satisfactory: Proceed
o Correct Work Call for Reinspection before Covering
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
JUlLDING INSPECTION OFFICE: 200 Fourtb Avenue West, Shakopee, MN 55379.1220
C~r the next inspection 24 hours in advance ./ ~
Owner/Contr. on site {OS {:e::.V Inspector ~~~~~_