08.b2 13260 182ND ST N - 2008 enclosurexi
CITY OF SCANDIA
Residential Addition Permit Application
Permit number(assigned by City):
Project Address:
PID number or legal description:33 - 02
Owner:3-17 772 YPhone
Z12-Address: J,Jz
A 10LGeneralContractor: :zz 42 State Lic. Y'1>
Purpose of permit:A)Z(64 2
Deck,accessory building(garage,pole barn,etc...),shed,pool,porch,room addition,or exterior expansions.
Description of Project: G,r'K&k, 4,)41'c 420t)L
Give use of space with rough dimensions. Plans are required for all projects including a survey or site plan.4
ic.
property line: front iDistancestopropei0/1-),sides back
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Estimated Valuation (include labor and material): 6, M6 J-
Notice: The applicant,upon signing this form,is responsible for work being done to the minimum of the 2007
MN Building Code. Homeowners should be aware that they take full responsibility when signing
this form and relinquish their rights to the Contractors Recovery Fund.
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Name[please print]:
Signature: Date:
Phone number to contact when permit is issued: 30300Cell-yes,
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NOTICE: Separate permits are required for electrical work and installation of septic systems.
All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions
k. of any other state or local law regulating construction or the performance of construction.
Building Permit Fee
Plan Review Fee
State Surcharge Fee
Contractor verification
0OtherP'1—A-"/U&-V-5
TOTAL
1.00)
BUILDING OFFICIAL SIGNATURE:
0
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41,20 - qz
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