HomeMy WebLinkAboutPermit 4048B11
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AP"".ICATION FOR BUILDING Pf""MIT
~COTT COUNTY, MINNES01",
Project Address
Post Ollice City
COUNTY USE ONLY ~~~...,.....-""'
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Permit number L./OLJ.~- ~-II
Receipt number j f:i37 '-f
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APPLICANT Fill OUT INFORMATION BELOW:
Applicant ~~jL 1l1/.k,,^- Phone (Home) 'NtJ-tc6fjlf (Work) SiJ7 - ~. 22<1'/
Address J-7t);:J.~u..<;A.f-",u.. /),J City ~ !...r..l<e State -MAl Zip 5'5"37l
Owner (if other than Applicant) Phone (Home) (Work)
Address City State Zip
Contractor Name
Address
State Contractor's License Number
:;. eJ P
City
Phone (Home)
State
(Work)
Zip
Project legal Desc.
See II lot
Parcel No. 110\-?fY~()
No. Acres
Block _ Subdivision Name
use: J(,e. - r~ 00+-
The above applicant applies lor a permit to'
(erect, construct. enlarge, alter, repair, move, improve, remove or conven as case may be)
(house. garage, deck, reroof,etc,)
,
Type 01 construction: Wood Masonry _Other _ Type 01 heating system
Dlmenslonsolstructure c9,s- .G'Q1.L5'-I~,
/g76oD
Estimated cost or value
Numberof Bedrooms
NOTE: A survey I. required by a registered surveyor for all new home applications on I.es than 10 acres.
If a survey is not required, a Plot Plan must be submitted. Please contact the Building Department for a complete list
of items required lor permit approval.
Applicant hereby agrees that, upon issuance 01 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 lor its permitted use.
41ft 1/.; ~
, A(>Plic~;Signature
9-dJ~ 9 g
Date
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~TOWNSHIPORCITYUSEONlY ~~~
Recommend Approval
Recommend Disapproval
~ubject to the following conditions:
Signature of Township or City Clerk (or representative)
Date
~~COUNTYORCITYPLANNINGUSEONlY~~
Minimum setbacks: Road Side Rear lakelCreeklWetlMd Zoning district
Approved Denied By Planning/Environmental Health, subject to existing regulations and the
lollowing conditions:
Signature Planning) Date
Signature (Environmental Health) Date
~~~_COUNTYBUllDINGUSEONlY~~
Approved Denied /.. By ~ld~Llicial subject to existing regulations and the lollowing conditions:
Signature /'/;.,.., ":~- Datey":":l:).qy
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Additional Comments:
FEES: land Use Permit
Sewer Installation Permit
Plumbing Permit
PlbgJMech. State Surcharge
Bldg. State Surcharge
Building Permit
Plan Check
J .00
8~.oo
2..1.~
Erosion Control
(3DLl) 56_4S.
TOTAL FEE
06600-2805 (1Q-961M)
White. County Yellow-Township Pink-Applicant Gold-Township
COUNTY Or SCOTT
INSPECTION NOTICE
PERMIT NO L10 l{ 8' - [) - II SCHEDULED
TOWNSHIP/CITY S. L... COMPLETED.B' - l- 9'7'
ADDRESS 1/0 ']J) iMlP'~'io....."V1 t< rJ
OWNER
CONTRACTOR'
PHONE: 496-8334 or 496-8475
DATE TIME
7,~ (")'
o FOOTING
o FOUNDATION
o FRAMING
>: 0 INSULATION
I- 0 WALL B~ ,..
~ KFINAL ~V"'O)+
.q; 0 PAOGRESS
(I) 0 DEMOl
~ 0 FIRE PREY
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o PLUMBING AI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTAll
o SEPTIC MAINT
o SEPTIC FINAL
o PLUMBING FINAL
n
o SITt INSPECTION
o EXCAVATING;GRADING/FILlING
o LAKESHOAElWETLANOS
o COMPLAINT
o FOLLOW-UP
o FIREPLACE/CHIMNEY THROAT
o FIREPLACE/CHIMNEY FINAL
o GAS LINE PRESSURE
o
COMMENTS:
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PROJECT COMPLETION OAT"
OWQRK SATISFACTORY PROCEED 0 PHOTO TAKEN
o CORRECT WORK & PROCEED
o CORRECT WOAK CALL FOR RElNSPECTIQN BEFORE COVERING
o CORAECT UNSAFE CONDITION WITHIN ___ HOURS INSPECTOR Will RETURN
o STOP WORK ORDER POSTE:D CAll INSPECTOR
o INSPECTION REQUIREO CALL TO ARRANGE ACCESS
BUilDING INSPECTION OFFICE
Courthouse Al02, 428 S. Holmes 51. Shakopee, MN 55379
Call for the nextlns~ctlon 24 hours in advance
Owner/Co'f;\ on site to~1
Inspector:J,.~ (lLo
06600-2807 (6-97 5M)
White Copy/Inspector's File Canary Copy/Records Pmk Copy/Site