2001-11-20 Grading Permit
P.O. Box 9
Albertville, MN 55301
CONTRACTOR'S LICENSE NO.
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2.
SECTION
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LOT
Date Notified: i
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Date"Pald:1
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Y
CITY OF ALBERTVILLE
BUILDING PERMIT
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.$
BLOCK
PARCEL NUMBER
(Address)
ADDITION
4. OWNER,
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PLAT NUMBER
(Name)
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5. ARCHITECT
(Tel. No.)
(Address)
?t.Jj<~
(Tel. No.)
(Tel. No.)
763 J 'l.~,
Plumbing 0
(Name) (~ddress)
l~-tI'C'/(l.."> \C.,J/,<'./
Fireplace 0 Septic 0 Heating 0
6. BUILDER
7. TYPE OF WORK'
New Construction 0
Finish Basement 0 Porch 0
8. SIZE OF STRUCTURE
(Height) (Width) (Depth)
11. COMPLETION DATE
/2.;.-
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',J
14. PROPOSED ELEVATION IN
RELATION TO CURB OR
WATERWA Y. ---=---.:. ELEV.
17. FRONTYARDsetback
from road property
Ft.
(/- 0 'ij,
Reroofing 0
Alterations 0
Addition 0
Residing 0
Finish Attic 0
Garage 0 Chimney 0
9. NO. OF STORIES
M i sc .:;"7- "U.L.~-I..
~E~iMATED VA,,",OE I
'_..s:~.--c;cr;-6'~.;;r ,
13. NO. OF FAMILIES (if applicable)
12. PROPERTY DIMENSION
Width ..Depth
15. PROPERTY AREA OR ACRES 16. CULVERT SIZE
Sq. Ft.
18. REAR YARD set back
Yes No
19. SIDE YARDS set back
Ft.
Right Sd.
Left Sd.
20. FLOOR AREA APPORTIONMENT USE
AGGREGATE FLOOR AREA
AREA
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I'
The undersigned hereby agrees that, in case such permit is granted, that all work
which shall be done and all materials which shall be used shall comply with the
plans and specifications therefor herewith submitted and with all the ordinances
of said City of Albertville.., applicable thereto.
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SIGNATURE,OF APPLICANT APP
.'
i''''- '.
Check Nq~Sh )
Permit N~~trZ I ~'~ C'j) ~.
Date IQ/;~ I~ I
I /
PERMIT FEE
PLAN CHECK FEE
PENALTY FEE
ENGINEERING FEE
SITE FEE
DRIVEWAY FEE
CULVERT $
FEES
3<\.15
21... (';B
FIREPLACE
PLUMBING FEE
SEPTIC FEE
MECHANICAL FEE,
WATER METER FEE
WATER FEE
SEWER FEE
SURCHARGE FEE
OTHERS
Ot 5('.)
CONTRACTORS LICENSE
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,.- /
TOTAL FEE
CODE ANALYSIS
TYPE OF CONST.
USE OF BLDG.
OCCUPANCY GROUP
OCCUPANCY LOAD
ZONING DISTRICT
VARIANCE GRANTED. DATE
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
MATERIAL FILED W/APPLlCATION
SOILS REPORT
o Borings
o Percolation
o Compaction tests
PLANS AND SPECS. 0 Sets
SURVEY 0
Copies
Sq. Ft.
ENERGY CALCULATIONS 0
PILING LOGS 0
Sq, Ft.
Sq. Ft.
FIRE SPRINKLERS REQUIRED
DYES 0 NO
SPECIAL APPROVALS
Sq. Ft.
ZONINGS
FIRE DEPT.
HEALTH DEPT.
PUBLIC WORKS
COUNTY
OTHERC 11~ EJJ (j,
CERTIFICATE OF OCCUPANCY ISSUED
DATE
BY
INSPECTION RECORD
DATE 'UIMA"KS INSPECTOR
FOUNDATIONS:
SET BACK
TRENCH
REINFORCING
FOUNDATION WALL &
WEATHER PROOFING .
CONCRETE SLAB
FRAMING
INSULATION
.
INT. LATHING OR DRYWALL
PLUMBING
SEPTIC
HEATING
MECHANICAL
FINAL
Use Space Below For Notes, Follow-up
& Septic Diagram etc.