HomeMy WebLinkAboutNo 13787 19
Valuation Water Unit
City of Lakeville 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 V
Building on Lot No. Block Subdivision
Parcel No.
in the CITY OF LAKEVILLE to be used as
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
~
~
~
~ =
~ ~
~ r
~ _
~
' A
z~ ~
c
_ -h
~ (a
APPLICATION FOR BUILDING PERMIT
CITY OF LAKEVILLE
8747 208th St. W. P.O. Box 957
Lakeville, MN 55044
• 469 -4431
Job Site Address : 1 C~~(~ ~ ~ (~4 i
Legal Description: Lot Block Addition
Owner iJ~\~: ~ 1 d ~ ) )r1 ~ 1~-, L ~ ,A ' i„ Phone ~
Address ~~i ~Y rDA ~i P .O.Box City~~;~~r y ! t E ZiP ~,5 ' y y
Contractor ~ t L~ Phone~~~ - / ~ b'I}
Address G~ ~ ~L,, ~ P.O.Box City ~ ~ Zip
~,~ti~,.,, il.~- ~S 331
Class of Work: ( rect ( )Alter ( )Repair ( )Enlarge ( )Move ( ) Demolish
Proposed Use (Describe in Detail) ~ ~ ~~•%'L,
Commercial: Square Feet Number of Employees
Heating Contractor
Plumbing Contractor
• Sewer & Water Contractor
Electrical Contractor
Special Conditions
Valuation of Work: $ ~%~~r~ „ L
ignature of Applicant & Title: FOR CITY USE ONLY
`z.
c- ~
~ ~ Zone
'y ll lr<.. ~<<~ ~"~L~ City Fee $
0
Date / J Plan Check $
Signature of Zoning Officer: Surcharge $ _'7 •G'Z ~ n1~,~w
SAC $
Date S/W Units $ C//~"
Signature of Building Inspector- Sewer Area $
- r\ St. Area $ '
• i,
Date ~ - Park or Misc . $
i
TOTAL $ ~ ~ ' ~ ~ ~