HomeMy WebLinkAboutPermit 2569B11
Tawnshlp/Clty
Sprir\1?; Lake
A,.....L1CATION FOR BUILDING P-'MIT
SCOTT COUNTY, MINNESO I A
- COUNTY USE ONLY - - - - - - - - - - - - - - - -
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Praject Address
Past Office City
17551 Mushtown Road
Prior Lake, MN
7ip 55372
Permit number
Receipt number
:15"69-,8-/1
do~5'1
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Applicant
Addres!'l
APPLICANT FILL OUT INFORMATION BELOW:
Davie Radanke Phane(Hame) 447-4780
17551 Mushtown Road City P. 1. State MN
Owner(ifatherthan Applicant) Same
Addres!'l
Cantractar Name"''' 1 f
Addres!'l
Phane (Hamel,
(Wark) Same
Zip 55372
(Wark)
Zip
(Wark)
Zip
Project Legal Desc. NE l SE l & PO NH l
Sa" 11 Lat Black _ Subdivisian Name
Theabaveapplicantappliesfarapermitta: 3uild a pole building
(erect, construct, enlarge, alter, repair, move, Improve, remove or convert as case may be)
State
Ph 'One (Home)
City State
Parcel No. 11-911-046-0
No. acres
48,-
r.ity
Type of construction: Wood
Dimensions of structure
Estimated cost arvalue
Masanry_Other....L Type of heating system
24' x 32' 'it. <;? xP .
.5. tr&O
Numberof Bedroom.
NOTE: A survey is required by a registered surveyor for all new home applications on Ie.. than 10 acres.
If a survey is not required, a Plat Plan must be submitted. Please contact the Building Department for 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 tow ip, city county ordinances. The applicant agrees to abide by all zoning
regulatians, and utilize this struct,ur/f r its r~.t~e~~ L
'-'<\ ?,,p .aJ&./fT 9-18-90
Applicant's Signature Date
~TOWNSHIPORCITYUSEONLY~~
Recommend Approval X Recommend Disapproval SUbject to the following conditions:
Ag Use Only _.
SignatureafTownshiporCityClerk(arrepresentative) &.d L1L~)JrA Date 9-13..90
~COUNTYORCITYPLANNINGiE~~LY~~
Minimum setbacks: Raad /c"~ I Sid.. 8 (J / Rear b () I Lake/CreektWetland 7'Oning district 1/;:'
Approved ~Denied By Pla,;~~onmental Health, subjectta existing regulatians and the
following conditions: czq ~ _ A~
Signature Planning) ;f ~./ ~~ 6 Date 9-';;'7)-'-0
Signature(Environmental Health) Date
~~~COUNTYBUILDINGUSEONLY~~
Approved
At-C-
y. Denied By Building Official subject to existing regulations and the following conditions:
L4 6 0 <. ~ ".,,, Tl- rr; ,nPc-T GD D/f!-
Signature 4 (,,/. 7~ DatL7-.2/- '10
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Additional Comments:
FEES: Land Use Permit
Sewer Installation Permit
Plumbing Permit
State Surcharge
Building Permit
Plan Check
,g.otJO
TOTAL FEE
61 O. {J-O
White-County Yellow-Township Pink-Applicant Gold-Township
08600-2805 (6-90 1 M)