HomeMy WebLinkAboutNo 12900 19
Valuation Water Unit
City of Lakevi I le Bldg. Permit Fee Sewer Unit
State Surcharge Street Area .
Metro SAC Charge Park Fee .
BUILDING PERMIT Other TOTAL PAID........ .
& Receipt
Permission is hereby granted to ' F ' ^ ~ >>''i~E?>?._._~.~.'~,.
Building on Lot No. Block Subdivision ~ ` - ''r ~ ' E•
Parcel No.
in the CITY OF LAKEVILLE to be used as t' `
This permit is issued on the express condition that the ERECTION 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 State of Minnesota pertaining to the construction of buildings.
Street Address
Director, License and Inspection
Callforinspections - 469-4431. BY
~ _
II
APPLICATION FOZ 3IIILD LNG ~ CIT° OF LA~PZLLF.
?~"SIl 8747 208th St. W., P.0.3oa 957
. Lakevil? e, . tL"i 55044
(612) 469-4431
Job Site Address ~ ~ ~ ~ ~ ~~~~4~ ~
,
Legal Description: Lot Block Addition
Qwner ~.~(~-T- I-~~~F' ~ Phone ~
Address ~i . ~ C= E' i% 1, City L~~ ~~-P Zip ~ C='
Contractor _~~7~(Z- ~ ~=~-~~'d~~ ~l,_>~ Phone ~ z
Address C oxJ~, ,_~~-l~:e. Zi
b- p
Class of Work: ( ) Erect ( ) Alter ( ) Repair ( ) Enlarge ( ) '_'Sove ( ) Demolish
Proposed IIse (Describe in Detail) ~ ~ ,r~ t ~p lq,-~..~ 'i
I
Commercial: Square Feet ~ Employees
Heating Contractor
Plumbing Contractor
Sewer & Water Contractor
Electrical Contractor
Special Conditions
Daluation of Worst: $ a ~ C~ ,
' FaR CIT'Z II5E ONL°
Signat~ire of Applicant tle
r.-~ Citp Fee $ ~
~ ~ Plan Check $
Date Surcharge $ 1 {
SAC - $
Signature of Zoning Of~icer:
• S/W IInits $
Date Sewer Area $
Signature of Building Of~icial: Street Area $
Park or Misc. $
Total $ ~ ~ ~
Date: ~
SZD MZLL~, BIIZLDL~IG INSPECTOR