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APPLICATION FOR BUILDING PERMIT / b {J-o - g:' -/ J..
Hlh .1\ OTT COUNTY, MINNESOTA PERMIT NUMBER
Owner: Name: ~ ~ Phone:!i.'-/7- 6f~O
Address: /16'11 ~ .~~ m~ 5~-~7~
Applicant: (lfotherthanowner)~e: Vf)~ ." 2 ~. .~dJ2~J .
Address: I tJ7'1fl -d~JAfk-(~__~~~./d' Phone:gn-~.2:5-
The above applicant applies for a pHrmit te" (J ,:>5 _
~ /tX.:lt ~ ~
(Buil~ait8r, repair, wreck ~a. case may be)
9S4'1J .f!?
PERMITS APPLIED FOR: (Check those applicable) BUILDING (Estimated Cost)
KIND OF CONSTRUCTION:
~ //)JEI~
Number of Bedrooms:
Legal Description of Property' tV lJ y"
Township: /1 t.( Section: II Range:__ ..2-1---or Lot: Block:
Zoning District: Agricultural: Residential: 1(-,,2., Commercial:
A Plot Plan showing the following must accompany this application:
1. North Direction 5. Street name or road number
2. Location of ProposeCl Structure on lot 6. Locations of existing structures
3. Dimensions of front and side set.back 7. Location and size of Septic Tank and Drainfield
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 wor~shall done and all m.aterials which
shall be used shall comply with the plans an~~ations herewith submi nd with the Ordinances of Said
Township and County applicable thereto~~~ ;'Jt~- I tJ- ~},- g.2--
GeneraIContractor:~-'u~ (B,<.1!"-4.
SUbdivision:~tL-'(1 .
Industrial:
Recommend Approval'
subject to the following conditions'
Reasons for disapproval: . \. .-
SIGNATURE OF TOWN CLERK: (Or representative) ...1.JJlJi."nSJ. ~
~
TOWNSHIP USE ONL"
Recommend Disapproval:
Approval recommended
nATE:lt1-/3-1l':J-
COUNTY USE ONLY
Approved: L--"" Denied: " . ~zOning Administr~tor SUbje~existi~ regulations ..!mlYheJollowing
conditions: ~r/~~' ~~K..U_...<<Jp 30 ~~j
SIGNATURE' -;&.u-LdL '/-,L'27:~;) / -;t"A DATF' IcJ-/"I-f?~
COU~ USE ONL'"
t/ Denied: By Bjing Official subject to existing regulations and the following
a.. ~ d~ nATF./()-/S"-rr.L..
1 --
Approved:
conditions:
Signature:
FEES: Zoning Permit
Sewer Installation Permit
Receipt# /9 009
Plumbing Permit
j(}.tHJ
Well Permit
Plan Check
,(:(/0
Yo.s-o
c/o J~-
State Surcharge
Building Permit
TOTAL FEE
/ 3~--: 7)-
1. County Copy (White) 2. Township Copy (Canary) 3, Applicant's Copy (Pink)
Form No.1
Revised 8-1-80
Form No. 294 Miller-Davu. Co., Minneapolis
~ ~;'!~~'1'1"":s,"f"'d-""-:::-~~t1....:;-~;;-...~t'~"tf~ott'''''::;-'':;;-'''''t'.....~...c:-,~~
~ 135.75 No, 1600-8-12 I
'. 15th October 1982 '
State of Mmnesota, "f'
County of
Scott
Office "If
IS.
IlllnOING Permit
IN CONSIDERATION OF The statements made b. Craig Plekkenpo1. p~ekkanpol
Bunders_ 10740 lvnda1e Ave. So.. Suite 14W. 810011inaton. Minnesota 55420
in h11....... application therefor duly filed in this office, which application is hereby made a part hereof, "
PERMISSION IS HEREBY GRANTED To said Craia P1ettenD01. BundeI' ,"or lI.lQ(owner
to. b!d1d an addition onto oresenthooJe
I' upon that tract of' land described as follows: Lot Block
Address . NWL Section 11
, which tract is of the size and area specified in said application,
I' This permit is granted upon the express conditions that said owner and h is contractors, agents, workers '
and employees, shall comply in all respects with the ordinances of the
CQuMv . of Scott ,
, ,
G' d th h d f th Building Official f 'd County d' t '
Iven un er e an 0 tJo 0 sat . ":\n Its corpora e
seal and attested bY~'ts 1110 ni~,.... his 15th day of OctQblr. .19_8
Attest: ~. ("/11 _ 4)J!.tZfl.i.,- ,
, /.NL_ (/,. ,,,{LiJ-)
Planninq Director Bui1diftp Official
"",. -l'~.-.l't'r'" .tt~~
. plat or additiol'
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