HomeMy WebLinkAboutNO 246 2
Serial No. 2~~~.t Permit No.
Address 16~i~7 -Dodd ~1vd•
W Name T m~ i t; Fri 1 Fr+ _
3 Address
o Ciry arr.~ln~ onR._Z71T1. Tel. No.
Name .
~ Address
City Tel. No.
V
I hereby certify that I have read this application and state that the
information is correct and agree to comply with the Lakeville Town-
ship, Minnesota ordinances and the State of Minnesota lows regulating
building construction.
Signature of
Permittee
Residential Fee S. 7/50
Commercial or Industrial Fee E
Other Fee S_
Penalty Fee
TOTAL FEE 3 ~
^ct. 2C~1j70
bate 19__
Approved '1i1 l `3.rd A . -Ar a:a.n
~ Sup;r. of Building Dept.
SITE ADDRlSS I DATE I PERMIT NO.
3lWAG! DISPOSAL CONTRACTOR
Residential ? Commercial ? Indtrial ?
fIUILDlR OR OWNER .Septic Tank
No. Concrete ? Cpn~C~e Block ?
C
Distance from well ~ ~ lye.' C~
< Cesspool f~ 1 +
No. m V~-°- D~Fth V"
Drain Field No p Sizel
r, R.EMARK3.
~ ~
r` 1
G' I
~ r
g
N
~
Called Inspection Inspection Date
Approved ? Disapproved ? yse~
Date
Inspector
~ -