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HomeMy WebLinkAboutNo 11079 1 ,i~,~ Village of Lakeville ~,,,,<~9 INSPECTION DEPARTMENT Building Permit..... Valuation 'J , i7C,1 BUILDING PERMIT s ~ 3.;~Y Building Permit Fee State Surcharge...... 1 _ `it s TOTAL FEE PAID.. ^ `7 - ~;~s ?~r~`z:~ ~ . ~r3.t: Permission is hereby granted to Building ott Lot Na Block Subdivision Pareol ~t^ w(-,~~-1r y_:~°kt1a;>. Plat .'a~Yz.~.~v, ik the `VILLAGE OF LAKEVILLE to be used as "-+•r .ai_~'1-z~`• ~ "~'M ~~r~" This permit is issued on .the express condition that the -ERECTION -ALTERATION -REPAIRS ENLARGEMENT-- _MOVWG -DEMOLITION respects #o the statemervts certified to in the applieallon for such permit, and tt?at all work shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and tho Stall of Minnesota pertaining to the construction of buildings. ~ Street Address ? ; :~+2 i' Director,, License and Inspection Attention is particularly called to the cutting up of streets, making main ~ sewer .connections, driveways and curbs. Obtain permit for suth construe- gy tion from .the VILLAGE OF LAKEVILLE. Inspection Department 'Not Re- ` sponsble for Any DamogesYO Public Utilities. I~ APPLICATION FOR BUILDING PERMIT ` CITY OF LAKEVILLE 8830 207th St. W. P.0. Box M Lakeville, MN 55044 469-4931 r Job Site Address: _ ~\~h,~~)~ \~i,~~_L;~.-'~ Legal Description: Lot Block Addition Owner ~ ; Phone Address ~~'~`~~+\°~~i Contractor ~ ' _ Phone Address Class of Work: ( )Erect ( )Alter ( )Repair ( )Enlarge ( )Move ( ) Demolish ' Proposed Use (Describe in Detail) r~ t ~ ~~11J~5~ ~l.J Heating Contractor Plumbing Contractor Sewer & Water Contractor Electrical Contractor Special Conditions Valuation of Work: $ Signature of Applicant & Title: FOR CITY USE ONLY ~ ~...~y, ` ~ .r ~ ~ Zone City Fee ^ ~ ~ Date ~ _ ~ Plan Check $ Signature of Zoning Officer: Surcharge $ ~ ..J~ SAC $ , Date Hook-ups $ Signature of Building Inspector: Area Charge $ Other $ Total $ r, Date