|
<br />VILLAGE OF ARDEN HILLS
<br />
<br />/'225'0
<br />
<br />1450 W. Highway 96, Arden Hills, Minnesota 55112
<br />633-5676
<br />
<br />, - ~
<br />
<br />BUILDING PERMIT NO.
<br />. Name C4~ I.... {i.t....Il-1t:\'II/ S I
<br />'!! Address /'3do T.v6T.re..5.d-./ R.D.
<br />3;
<br />o City l/J2.b ~'II' Tel. No. ~ ">,, -0 ~ '1
<br />0: Name {i'/...lvt 11.\J' ~ r C" N S,.
<br />,0
<br />6 G Address ., I Ie. /1.-t-1~
<br />o~ /""i
<br />t- City S , I~ V L Tel No.
<br />S4- e:...
<br />
<br />
<br />~ ':r
<br />
<br />1-0:
<br />Ow
<br />Ww
<br />t:z
<br />r-
<br />oC!)
<br />a:Z
<br />..:W
<br />
<br />Name
<br />
<br />Address
<br />
<br />City
<br />
<br />Tel No.
<br />
<br />Registration Number
<br />
<br />Structure
<br />Used As
<br />
<br />R.
<br />
<br />U.,,,,,r
<br />
<br />Zone
<br />
<br />
<br />DO NOT WRITE IN THIS SPACE
<br />/99: 00
<br />Permit Fee...... .. ... .. _. ......... .$
<br />.?o
<br />
<br />State Surcharge
<br />
<br />"" .$
<br />
<br />Plan Check Fee ....
<br />
<br />"" ,,$
<br />,." ,,$
<br />"". ,,$
<br />
<br />00.00
<br />
<br />SAC Charge (Units)
<br />
<br />Other. __.
<br />
<br />$
<br />$
<br />
<br />Penalty,. ,..' ,.,.. ,.. , ... , ,... ,... ,$
<br />
<br />TOTAL FEE PAID. "..".,.", ,$
<br />Receipt No. /..t, t, <f Date
<br />
<br />
<br />DEMOLISH
<br />D
<br />
<br />ALTER
<br />D
<br />
<br />MOVE
<br />D
<br />
<br />REPAIR
<br />D
<br />
<br />BUILD
<br />~
<br />
<br />ADD
<br />D
<br />
<br />LOT
<br />
<br />BLOCK
<br />
<br />ADDITION OR TRACT
<br />
<br />/
<br />
<br />~
<br />JOS'EP/-/N./E fi/L-L.1" :.?
<br />
<br />LEGAL DESCRIPTION
<br />
<br />1.2
<br />
<br />WIDTH
<br />
<br />SETBACK
<br />
<br />
<br />DEPTH
<br />
<br />SIDE YARD I
<br />lo~ 2'S"1
<br />
<br />I 'L '5"
<br />
<br />}2S
<br />
<br />WIDTH
<br />
<br />LENGTH
<br />
<br />SETBACK
<br />
<br />FRONT YARD
<br />Lit:) ,
<br />
<br />~ I
<br />V
<br />
<br />HEIGHT
<br />
<br />TYPE OF CONSTRUCTION
<br />
<br />ESTIMATED VALUE
<br />
<br />STRUCTURE
<br />DETAILS
<br />
<br />~1 !.-.O'f
<br />
<br />32-' !'irf--a/t'
<br />
<br />I MAr-IE
<br />
<br />7tJ"oo 0
<br />VAL FOR SURCHARGE
<br />&-
<br />55.;201:1 -
<br />
<br />DETAILS OR REMARKS:
<br />
<br />NOTICE
<br />
<br />SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,
<br />PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING,
<br />
<br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR
<br />CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN
<br />120 DA YS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
<br />ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME
<br />AFTER WORK IS COMMENCED.
<br />
<br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS
<br />APPLICATION AND KNOW THE SAME TO BE TRUE AND
<br />CORRECT. ALL PROVISION OF LAWS AND ORDINANCES
<br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH
<br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A
<br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO
<br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER
<br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE
<br />PERFORMANCE OF CONSTRUCTION... /
<br />
<br />Nt!' r--<1
<br />
<br />
<br />(DATE)
<br />
<br />(OA TE~
<br />
<br />~~2 7f5
<br />
<br />(DATE)
<br />
<br />00 NOT WRITE IN THIS SPACE
<br />
<br />Typeof Occupancy Division
<br />Coo". Y-N G,,"P T-J 1-
<br />Size of Bldg. /,;z~ 3 No. OJ Max.
<br />(Tolal) Sq. FL Slori:S-,oL.-.1 -r Occ. load -
<br />/~..?r
<br />Fire U,. f2
<br />Zone ":trI::' Zone Required RYes 0 No
<br /> .s~pdc .l>Z-'.
<br />No.ol OFF STREET PAAKING Spr~ES:
<br />Dwelling Units I Covered e,.....-"" Uncovered .
<br />Special Approvals Required Received Not Aequirea
<br />BOARD OF APPEAL
<br />PLANNING COMM.
<br />VILLAGE COUNCIL
<br />SPECIAL USE
<br />FIRE DEPT.
<br />SOil REPORT
<br />OTHER
<br />
|