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HomeMy WebLinkAboutNo 13987 ` s i A~=az~t :37 t 19 ~ i Valuation ~'rJ , 'I ~ _ tin Water Unit . . Clty Of Lak@VI~~B Bldg. Permit Fee • Sewer Unit State Surcharge ` ~ ~ • fir' J Street Area . MetroBAC Charge....... t~ d'~~~ Park Fee . BUILDING PERMIT ~ther..~`.~-ar?..G~t~~~?:.. ToTA~ P,e;~o:....... Receipt ~ ~ ~ Permission is hereby granted to t~~ ~~~+'~~'~~`k~ ("c~ra a~hct'r~r~Rf$ ~ta~rir~-trj~~~r Building on LotNo. ~ Block 1- Subdivision. taeishSar ~.ddn Parcel No. ~?-~.~~~r5=G3t~°G~: in the CITY OF LAKEVILLE to be used as ~~L7nit tcs ccs°t~t~~~ct ~in~I~ ~~aml ~~l'> This permit is issued on theexpressconditionthatthe ERECTIOtV _ ALTERATION REPAIRS ENLARGEMENT MOVING DEMOLITION respects to the statements certified to in the. application for such permit, and that all work shall be done in accordance-with the Ordinance of LAKEVILLE, Minnesota and the Stateaf Minnesota pertaining to the construction ofbuildings. Street Address ~i1i ~~y D~wi~ E. k~xin~s li~ Director, License and Inspection l , '7 7 Call for inspections-469-4431. By-t ~ ~ ~ " ` ~ ^ ; - ~ I ~ - H o~ ~ ~~z~~ o ~ ~ ~ o ~ ~ ~ ~ ~ ~ ~ ~ BUILDING PERMIT APPLICATION '1 ~ ~ ~ ~ (,~;It, ~ ° ONE AND TWO FAMILY RESIDENTIAL y ~S ~ ~ ~ _ Q' CITY OF LAKEV TLLE INSPECTION DEPARTMENT 8747 208TH STREET W. P.O. BOX 957 LAKEVILLE, MN 55044 469-4431 DATE : ~ t JOB SITE ADDRESS: ~t.-~-~.- Gt1E/ SN,9t} iC' ~ LEGAL DESCRIPTION: LOT:~~ BLOCK:_l_ SUBDIVI ON OR SECTION; OWNER: ~7 ~ fl` S v`»~i~ G.E PHONE : 7~ ~ . 7 4% 1 / STREET ADDRESS : ~ ~'"y'~f ..,~dC' Si L CITY : ~vr ..ZIP : t~~~ CONTRACTOR: ~ ~1'1 ~z.c~,~.~'c:,~. PHONE: ~ - J STREET ADDRESS: /,$~y'G~ -._,~j~~'~~' CITY: ~,?~f~',~r~i`io=~,;.. ZIP: /`~,~i~t1. CLASS OF WORK: NEW:~ ADDITION: ALTER/REMODEL: DEMOLISH: PROPOSED USE (DESCRIBE IN DETAIL) : ~ p'~~Gc S(Z~ 1~ -~,i1„ ~l VALUATION OF WORK (EXCLUDING LAND): =e3 I HEREBY APPLY FOR A BUILDING PERMIT AND I ACKNOWLEDGE THAT THE INFORMATION ABOVE IS COMPLETE AND ACCURATE; THAT THE WORK WILL BE IN CONFORMANCE WITH THE ORDINANCES AND CODES OF THE CITY AND WITH THE STATE BUILDING CODE; THAT I UNDERSTAND THIS IS NOT A PERMIT AND WORK IS `NOT TO START WITHOUT A PERMIT; AND THAT THE WORK WILL BE IN ACCORDANCE [dITH THE APPROVED PLAN. -~~j~.~~s.~~ FOR CITY USE ONLY ~~v Applicant's Signature: C~~ ~1 rL-° ~t*.~ Date:7~7~=,t'C Zone ~ ~ ~2~g~P Permit Fee $ J " Plan Check $ ~ (~q Building .Official 's Signature: p Surcharge $ ~ • J~D Date: p SAC $ ~ 7~• Comments: S/W Units $ Sewer Area $ Park or Misc. $ TOTAL DUE $