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2016-00439-permit voided
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1050 Edgewood Hills Road - 02-117-23-13-0003
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2016-00439-permit voided
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Last modified
8/22/2023 4:06:22 PM
Creation date
8/23/2016 11:43:44 AM
Metadata
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Template:
x Address Old
House Number
1050
Street Name
Edgewood Hills
Street Type
Road
Address
1050 Edgewood Hills Rd
Document Type
Permits/Inspections
PIN
0211723130003
Supplemental fields
ProcessedPID
Updated
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.i� <br /> REQUIRED SUBMITTALS: <br /> All of the information must be submitted in order for your application to be processed: <br /> Not <br /> Enclosed Applicable <br /> � ❑ Buildin Permit Escrow A reement and Fees <br /> �1 ❑ Plan Review Fee <br /> ❑ Com leted A plication Form <br /> ❑ Proposed Pool or Hot Tub Plans—2 sets, full-size, to scale <br /> � ❑ Survey—2 full size, to scale (meetin ALL survey requirements) <br /> ❑ � Hardcover Information <br /> ❑ I� Septic S stem Certification <br /> �7 ❑ Minnehaha Creek Watershed District (MCWD) Permit or <br /> documentation from MCWD statin no ermit is re uired <br /> ❑ Landscape Walls and/or Retainin Wall Plans <br /> ❑ � Stormwater Pollution Prevention Plan <br /> �1 ❑ Data Privac Advisor Form <br /> ❑ ❑ <br /> APPLICANT ACKNOWLEDGEMENT: <br /> • Agrees to provide all information required or requested by the Planning & Building Departments; <br /> i <br /> ' • Understands, if applicable, an as-built survey and as-built hardcover cover calculations, are required to be submitted after the <br /> project is complete( including final grading and landscaping)prior to refunding the escrow; <br /> • Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are <br /> ' solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to <br /> reject it until it is complete; <br /> ' • Some or all of the information that you are asked to provide on this application is classified by State law as either private or <br /> confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. <br /> Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and <br /> intended use of this information is to annually update our records and records of other governmental agencies required by law. If <br /> you refuse to supply the information, the permit may not be issued. <br /> ApplicanYs Signature: Date: 2/ �Jr(G <br /> Owner'sSignature ���,`Z.�()(�� I �r S�/�� Date: �-1/ /��O <br /> Packet Last Updated: August 2015 <br /> Page 23 <br />
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