HomeMy WebLinkAboutNo 13388 ~1~r~ ~ 19 ~
Valuation ? ~ k 7+~'~ Water Unit
Clty Of LakeVl Ile Bldg. Permit Fee ~ • ~yE'r sewer Unit
State Surcharge • °~"I Street Area
Metro SAC Charge Park Fee . .
BUILDING PERMIT Other ..~e~.~S~d..4~:'~~'~~. r~?.~c~ ToTA~ PAID.. ~~3l.flt}
Receipt
Permission is hereby granted to ~~C' ~-j'-~~t.~~~~f(~L~~~p'r;~ C~~Y'tet',
Building on Lot No. Block Subdivision ° ~t ` Z 24'x' 2~
Parcel. No.
in the CITY OF LAKEV1LLEto be used as CC3tl.~'~Y'Ut: t ltd' x29 Y a~i~.i.t~.azt exist.~`ng ~~~aellin~
i
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.
StreefAddress 2~J~2 Dodd :31vr~ :1;xvici ~:r~:ng~s
Director, License and Inspection
Call for inspections - 469-4431. BY ~ ' ' ~ t '4"""
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BUILDING PERMIT APPLICATION
ONE AND TWO FAMILY RESIDENTIAL
CITY OF LAKEVILLE
INSPECTION DEPARTMENT
8747 208TH STREET W.
P.O. BOX 957
LAKEVILLE, MN 55044
469-4431
~-~2,1
DATE:
JOB SITE ADDRESS : ~ Q a d ~ N ~ ~
LEGAL DESCRI/PTION: LOT: ~rO~ BLOCK:~~ SUBDIVISION OR SECT,~IJON;
OWNER : ~ / / ,T ~o ~ G( ( - ~ GZ %
~ PHONE : % l - tF~ ~~S
STREET ADDRESS : ~ ~ G ~ ~ ~ ~/c/r CITY : L t ZIP : U ~l i~ `f~y'
CONTRACTOR : ~ ! / ~ ~~4 ~ ,~(~Q"/~ PHONE : ~Lp
STREET ADDRESS: ~'v ZIP: `-S
l ~ ~C?~1 (s2(;~~'~ CITY: ~l
CLASS OF WORK: NEW ADDITION: ~ ALTER/REMODEL: DEMOLISH:
PROPOSED USE (DESCRIBE IN DETAIL) : ~G[G~j'~r v-ti~l ~ G~?'~_
! >C7`~Cv3,ovu D ~ T-c~J ~¢~~'oo •°rs
VALUATION OF WORK (EXCLUDING LAND): ! U ~
I HEREBY APPLY FOR A BUILDING PERMIT AND I ACKNOWLEDGE THAT THE INFORMATION
ABOVE IS COMPLETE AND ACCURATE; THAT THE WORK WILL BE IN CONFORMANCE WITH
THE ORDINANCES AND CODES OF THE CITY AND WITH THE STATE BUILDING CODE; THAT
I UNDERSTAND THZS IS NOT A PERMIT AND WORK IS NOT TO START WITHOUT A PERMITS
AND THAT THE WORK WILL BE IN ACCORDANCE GIITH THE APPROVED PLAN.
Applicant's Signature: FOR CITY USE ONLY
Date: ~ ~ Zone 2
Permit Fee $ / 3 S 40
Plan Check $ ~ ~ O f~
Building Official `s Signature: G~ Q~
/Surcharge $ /
Date:
•
SAC $
Comments : Q(~,~/2 (,l~/GL ~j C,/~~/
S/W Units $
~~1"f~"tc~1T~ ~ ~v~eU~-Y a
~ ~ Sewer Area $
f,:
Park or Misc. $
_w r-----
TOTAL DUE $ % 3 / U D