HomeMy WebLinkAboutNo 11319 ~ ~ ~ ~ Village of Lakeville , i,;.
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INSPECTION DEPARTMENT Building Permit.....
BUILDING PERMIT valoction . ~ ~ 7nt
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'..-~•t~n,Lt~: Building Permit Fee
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State Surcharge....: '
TOTAL FEE PAID . ~ ~
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Permission is hereby granted to
Building. on Lat No. Block Subdivision - ,
PareN ,°lrs,, Plaf
ih the VILLAGE OF LAKEViLLE to be used as "m'~- ~ r `'~r~ ~t'"'•~-` r ~ '-~j.~-; fir:~.~• ' ~E i.~~.
This permit Is issued. on the exproas condition that the -ERECTION -ALTERATION ~REPAlIRS
-ENLARGEMENT -MOVING -DEMOLITION rospects to the statements certified to in ffie epplieatlon for
such permit, and that all work shall be done in accordance with the Ordinance of AKEVILLE, Minnesota and the Stall
of Minnesota.. pertaining to the construction of buildings.
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.Street Address ' ' '
Direotor, Lietnse anQ Inspitction
Attention is particularly called to the cu»ing up of streets, making main
sewer connections, driveways and curbs. Obtain permit for such construe- By ~ ,.~~;N-' ~'~~°`r•
tion from the VILLAGE OF'LAKEVILLE. inspection Department Not Re-
sponsible For Any Damages to Public Ltilities.
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APPLICATION FOR BUILDING PERMIT
CITY. OF LAKEVILLE
8747 208th St. W. P.O. Box M
Lakeville, MN 55044
46°--4431
,lob Site Address : ~J e~~~/ .
Legal Description: Lot Block Addition
C)wner
J Phone
Addre~"" /I ~J ~fiL-mac..-~~~j~ L~ Z~ ~ ~ ,2;,. ~~<< r,.
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Contractor 1~,,,~s Phone ,jam
Address
Class of Work: Erect ( )Alter ( )Repair ( )Enlarge ( )Move ( ) Demolish
Proposed Use (Describe in Detail)
Heating Contractor ~
Plumbing Contractor
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Sewer & Water Contractor'
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Electrical Contractor - -C...
Special Conditions
Valuation of Work:. $
Signature of Applicant & Title: FOR CITY USE ONLY
_ Zone
ice,
City Fee $ ,
Date ~ Plan Check $ r
Signature of Zoning Officer: Surcharge $ ems., »~~LL~°
SAC $ of U~ - '`~~3
Date Hook-ups $
Signature of Building Inspector: Area Charge $
Other $
Total $ S~ r
Date