HomeMy WebLinkAboutPermit 2052B12
APPLICATION FOR BUILDING PERMIT
SCOTT COUNTY, MINNESOTA
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PROJECT ADDRESS: /1;;<. LJo ~/)~rrl,q M;f; .
APPLICANT NAME: -=r;:: hr. if? _ d\ I", Y) (I (Y /1 J
ADDRESS: /7~KO j--:::-1flA-7?1,<} rive.
OWNER (If other than Applicant): r:.0 <<" f;.; r
ADDRESS: /7 .:::? L/ /") PAil rf rJ"1 /I Au fJ .
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TOWN~HIP ci::l
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PERMIT NUMBER
JY 1.9l?
RECEIPT NUMBER
HOME PHONE:.Z.?' 7-S7J1z!/
WORK PHONE' $I Ij 7 ~ did. I..J
HOME PHONF'
WORK PHONF'
CONTRACTOR NAM~'
ADDRESS:
PHONE:
The above applicant applies for a permit to:
1Sa,-;d Pr>.J::.
(Build, alter, repair, move, install, as case may be)
TYPE OF CONSTRUCTION: WOOd V Masonry_Other_ TYPE OF HEATING SYSTEM'
DIMENSIONS OF STRUCTURE: pi X In I t2nW
ESTIMATED COST OR VALUF' ~ L/ rtJ/? 7d<J NUMBER/OF POTENTIAL BEDROOMS:
LEGAL DESCRIPTION OF PROPERTY: So. 7< ?o..t U"',,: 1/../.0-(('5 A#.J\ C;;...<t.tI /; k4f IlK, IKw'f<- M
SECTION: /1 LOT' -d ~ BLOCK: SUBDIVISION NAME: S'(oi'r Gt,~1,/
NUMBER OF ACRES: TAX PARCEL NUMBER: ZONING DISTRICT'
NOTE: A SURVEY IS REQUIRED BY A REGISTERED SURVEYOR FOR ALL NEW HOME APPLICATIONS 0010 ACRES or LESS.
A Plot Plan showing the following must accompany this application:
1. North Direction. 4. Dimension of structure(s).
2. Location of Proposed Structure on lot. 5. Street name or road number.
3. Dimensions of front and side-set back. 6. locations of existing structures.
Applicant hereby agrees that, in case above permit is granted. that all work shall be done and all materials .which shall be used comply with the
plans and specifications herewith submitted and with the Ordinances of nship and County Applicable thereto.
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7. Location and size of Septic Tank and Dralnfleld.
8. Location of well.
/11m. I n/ 9.J?h
Date
TOWNSHIP USE ONL'-
Recommend Approval' / Recommend Disapproval:
subject to the following conditions:
SIGNATURE OF TOWN CLERK: (Or representative' PA~~~""r.f.-"...l~E:_4-/J?-$7
COUNTY USE ONLY
Approved: ~ Denied' By Zoning Administrator subject to existing regulations and the following
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SIGNATURE: ~~/f~' DATE:,p-/F-87
COUNTY 't'E ONLY
A,Rproved' ~ Denied' By Building Ojflcial subject to existing regulations and the fOllowjng condit ons:
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SIGNATUR~' d ~ r7 4~ DATE: .2-/9-;-"
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ADDITIONAL COMMENTS:
FEES: Land Use Permit
Sewer Installation Permit
Plumbing Permit
Well Permit
State Surcharge
Building Permit /)6 / r~(.'
Plan CheCk
Fireplace/WOOd Burning
Appliance
TOTAL FEE
,so
3 ? t'O
3g.S0
_2805
Revised 6.85
1. Inlpector'l Copy (Whita) 2. To_....p Copy (Canary) 3. App8c:Mt'l Copy (Pink)
COUNTY OF SCOTT
INSPECTION NOTICE CALLED.IN
PERMIT NO. a.CI5";)~ SCHEDULED
TOWNSHIP/~ c::::; '- COMPLETED
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OWNER !'l. / ' PHONE:
CONTRACTOR:
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ADDRESS
n FOOTING
(] FRAMING
CJ INSULATION
["] WALL BO.
W'FINAL
....Ii' PFIOQRESS
>; 0 DEMQl.
t: [] FIRE PREV.
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[] PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL.
o SEPTIC MAIN1.
o PLUMBING FINAL
COMMENTS:
.
DATE
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TIME
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o SITe INSPECTION
o EXCAVATING/GRADING/FIL.L1NG
o LAKESHORE/WETLANDS
o COMPLAINT
o FOlLOW.UP
~ SEPTIC FINAL
o FIREPLACE/CHIMNEY
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{'J WORK SATISFACTORY: PROCEED 0 PHOTO TAKEN
[J CORRECT WORK & PRoceED
n CORRECTWQAK. CALL FOR REINSPECTION BeFORE COVERING
n CORRECT UNSAFE CONDITION WITHIN HOURS. INSPECTOR WILL RETURN.
o STOP ORDER POSTED. CALL INSPECTOR.
n INSPECTION REQUIRED. CALL TO ARRANGE ACCESS.
OFRCE OF PlANNING, INSPECTIONS A~~ eNVIRONMENTAL HEALTH 496.8334
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OWnerfContr. on site
Inspector
06600-2807 (12-88 3M)
Whitt C.py/ln.pect.... F1II Clnory C.py/Rlcord. PInk Copy/Sill
JOHN M\J.NDAHL dl'~k
NAME
INSPECTION CHECK LIST
;J.OS;)-6-.9-. 1, ??~n
USE PERMIT NUMBER
DATE
2. -1'1r'g?
Plan Review
Sewer/Site Inspection
Permit Issued
'Footing Inspection
Heating Inspection
Plumbing R.ln Inspection
Plumbing Final Inspection
Electrical Inspection
Framing Inspection
Insulation Inspection
Fireplace Inspection
Wallboard Inspection
Individual Sewer
Final Occupancy
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ADDRESS
NAME
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