HomeMy WebLinkAboutNo 11157 ~ - ~ ~ Village of Lakeville - ,:.I~,
INSPECTION DEPARTMENT IEtuitdie~IP.r~nit....._
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EUILDING? PERMIT • • j
4 ~ 8uitdieg Permit Pes
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Stwte Serchorge . , . r • -
TOTAL FEE"PAID. ~l
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~sCifw ~X `'ii1wE~.re .z.';'t' 4~1~ C':; x ~G7'"1!~y'4
P~=rsaissoa~ is t+ereby grontad to
~:,i~~?r~ry un Lot Pto. 81ock Subdivision F' ' - '
tFfe 1Lt.AGE ®i` i~?KEt1tLLE to bs used as L', c~t-+~.st: ~~c> s f; :...~'~1.P.<~*~1,,;_
7°#tis q~rnatt is isattod mn ,the express condition that the __._RR~CTtOft .~ALTERA'f1UN ®RFPAlRS
~....oEMtwN1RGJ=tdEt3T ...®.fll0di#1G ~OftiAOLJTtONrespects to the steternents c+artifitad to in fhe eppllcatlen tolr
such g~errrnit, attd that -alt work shat! be done" in aceordaneewith the Ordinance of LAKEYIILE, Minttssota and the Stste
r,f iytin~;vta pertasnintp to the construction of buitdrps.
Street Address
Otreeto~ Liglnse an4 ttu~stlpet
Atten.~ic~rr es ~SO~rticu6arly coiled to the' cutting up of st'astf, maki~q enoin , _
sewsar corat+estions, driveways and curbs. ~t<!VA permit for such construe- gy y--;? ~ y'%'~ ~ - '
tron from the V"titAGE OF LAKEVILLE: Inspection Deportment Not Re-
sponsible for Any Damages to Public Utilities.
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1 $
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APPLICATION FOR BUILDING PERMIT
CITY OF LAKEVILLE
8830 207th St. W. P.O. Box M
Lakeville, MN 55044
469-4931
,lob Site Add
ress' --r~D ~(7 ~
Legal Description: Lot Block Addition ~j ~
Owner= ~ _ 7~ E~C Phone 7 l~ ~ rS~.i~
Address r7 r/ ~ , F-7~G=7-.~
Contractor ~ ~ijj Phone
Address
Class of Work: ( )Erect ( )Alter ( )Repair (,")Enlarge ( )Move ( ) Demolish
Proposed Use (Describe in Detail) j/~ ~j dal,,~r'n~./
Heating .Contractor
Plumbing Contractor
Sewer & Water Contractor
Electrical Contractor
Special Conditions
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Valuation of Work: $ ~ ;
Signature of Applicant & Title: FOR CITY USE ONLY
Zone f~,
c ~
City Fee $
Date Plan Check. $ ~
"
Signature of Zoning Officer: Surcharge $ ~O
SAC $
. Date Hook-ups
Signature of Building Inspector: Area Charge $
Other $
Total $ - j C'
Date