HomeMy WebLinkAboutBuilding Permit from Scott County 1973 I
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t /A ' 1 ..ICATION FOR BUILDING PEOT
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row/sHIPi SCOTT COUNTY, MINNESOTA .15-HY.;;Z -18--/4
PERMIT NUMBER
Owner: Name: _{.1.-14-....., ,,4--_-&-:/________,-_1(4-4-.4 ---
Applicant: (If other than owner) Name: ----
Pho e:
The above applicant applies for a permit to 1:11-4-,---61 ..,--0,---:-".4 /04-,......_:.4 AL----,--a--7
(Build, alter, repair, wreck - as case may be) ›..1
PERMITS APPLIED FOR: (Check those applicable) BUILDING (Estimated Cost) c)C;
IND. SEWAGE DISPOSAL SYSTEM: .4. .-ef....4..
- --~_~_
Number of Bedrooms 3 ---
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/ Description of Property- - �enero/ Con
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Township: ��------ Section: l»q Range: 2- t�, Lok��� "
Zoning District: Agricultural: - ��- /B|oc�' '------ Subdivision:
Residential: ~ --�
A^ pk� Plan showing the following muatoccomponyth�---~- � �omm»z�L Industria
1. North Directionapplication:
2. Location of Proposed structure on lot 5. Street name or road number
3. Dimensions of front and side set-back8' Loco�iP»u of existing structures
4. Dimension' of structure (s) �' Location and size of Septic Tank and Drainfield
" . 8. Location of well-Distance from 5ephcTank and Onoi fi
|64pp|icont hereby agreesthat, in co«eobo«ePprmitiu granted, that all work shall bedoneon6 all materials which shall
used shall comply with the plans and submitted and with the Ordinances of Said Township
County applicable thereto.
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Anna �ssnnnm� --
TOWNSHIP USE ONLY
Recommend Approval: � ~"~
Recommend Disa / ----�
subject to the following conditions: pp«z«o ' Approval recommended
Reasons for disapproval:
SIGNATURE OF TOWN CLERK: (Or representative)
� DATE: -
COUNTY �E ONLY
^ ' —
Approved: 1.---------Denied:
following conditions:
' By Planning and Zoning Coordinator subject to existing regulations------~~^
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SIGN4JURE. = -~~,�° �z-'a
e , di =#
DATE: Y/Z'V.Z.3
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3 ~*FEESPAID. BUILDING PERMIT - t 6 :.� .5^ umyIND. SEWAGE DIS. -_ "" il S---
-._____
WELL TOTAL FEE
$----/--ei-vegc-aL(,A
INSPECTIONS: Type- RECEIPT NUMBER: -- �
Type: -44(-___0 ^ <
Date:
Type:
3_47:::____
FORM NO. / ~-----' ~~t= K�
(Rev. //'/4�p —
^ " 100ry / �^ ��rf~ ��»^ V72
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