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Pre 1987 Permit
_ - - - _ ~ / _a _a ~ F ~ _ - - x ~ ~ i x tie w~.: i~ u~ DATE BY a .~~`~L~ DATE ~ C~T'~ ©F ~.~KE'~1 LLB BUlIDlNG INSPECTION DEPARTMENT - (612) 469-4431 APPLICATION FOR. ~iEATiNG PERMIT Site Address: ~®~r~ r/ ~ Alter Repair Legal: Lot Block Addition install Replace MAKE _ .L/~~nx' TYPE OF Y S STEM SIZE ~ ~ ~ Warm Air Plants CONN. LOAD Gravity FUEL _ ~ /~S Mechanical 1~ FLUE D1A. ~ fr Air Conditioning SUPPLY OPENINGS ~ Vent System RETURN OPENINGS Heating or Power Plont INPUT _ IC~ OUTPUT ~5' ~o U Steam i Hot Water EDR Radiation CFM Plan No. Date Est. Comp. Date Est. Coss Heating Permit Fee Commercial Contract Amount $ State Surcharge Total Permit Fees Owner's Name Address ~ ~ ~ Heatin ~ Tel. ~6 ~ ~ ,J g Contractor Address ~ / City Zip Heating, Air Conditioning, Ventilation $ Refrigeration Permit Fee for single family residence in- stoilotion ($39.50 + _SO surcharge) Alterotion or RepoirMin. Fee_.(i19.$0 ~ _50 surcharge) ~ Non Residential Fee shoit be computed at i ~a of the contract up to $I0, 000; for balance ove= $10,000 + :50 surcharge. Minimum=$24.50+.50____________$ (GAS PIPING INCLUDED) Send application and heat loss calculation with check for Permits to: C~TI ©F LAKE'~/1LLE Glenn A. (Barney) Langard Inspection Department Notice: ~ Plumbing & Heatjng Inspector Box 957 Call for inspection when Lakeville, MN 55044 wore is completed. City of Lakeville necember 22, y,s HEATING PERMIT & Receipt Permit Fee li3.5fl State Surcharge .50 TOTAL FEE PAID 2Q • QQ Permission is hereby granted to Farmington Heating/Richard Clemmer, Qwner 8uiiding on Lot No. Block Subdivision Pt of Sec. 32, Twn.114,R.20 Parcel ~~22-t3320Q-033-33 in the CITY OF LAKEVILLEtobeusedas permit to replace furnace in existing hawse This permit is issued on the express condition that the --ERECTION ~~4LTERATION REPAIRS -INSTALLATION 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 21338 D#dd Blvd Glenn A. Langord Director, License and Inspection r CALL FOR INSPECTION - 469-4431 By ~ . n ; e _ w - ` ~ j. i City of',Lakeville May 20, ~ s~ ' ? ~ INSPECTION ~ DEPARTMENT SEWER AND WATER PERMIT Permit Fee..........- 19.50 AiVD RECEIPT State Surcharge 'S0 TOTAL FEE PAID . 2.0.00 Dick Thompson, Excavator .Permission is Mnby grontsd-to Pt of: Sect. 32 T114~R20 Building. on Lot No. Block Subdivision PArcel 22-03200-030-33 Plat in theCt7YOF LAKEVILLE to beused as permit to repair private septic system _ This permit is issued on .the express coridifion that the _ERE`GTION .ALTERATION REPAIRS X INSTALLMENT -MOVINGDEMOLITION 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. .a Stnef .Address 2133F3 Dodd Blvd G1 c~nn A - T.a ~nrrl -AttentlOn ib partlalAary caliad to the cutting up of streets, making main sewer connections. drweways and Director, litJnse JM InspJttlon Clrxbti."ObtBYI permit far such construction from the CITY OF LAKEVILLE. Inspecton Department Not f Rssponslbb ForAny Damegea to PuoNc Utllitres. ` ~1 gg The peIn111.hOlder Understands and agrees that granting this permit is not a warranty or representation by f' 1 ~ the l`qy that the project wIN be safe or satlgfectory. ~ The permit holder understands and agrees that the City shallhave the right to make periodic inspection By ~ ~ i durNp ratetruction. ff the permit holder loos not make arrangement for the inspection the Gry may cum off fli9 water urtlifsuch krspectlon has been made. f ~ T r, x _ ~,r.. a ~ ~ ~ ~ ~~,5' ' , \c~ . ~ ~ ` ~ ~ ~ ~ r ~ I, ~ r . SEWER AND WATER PERMIT APPLICATION CITY OF LAKEVILLE INSPECTION DEPARTMENT 8747 208TH STREET. WEST ' P.O. BOX 957 LAKEVILLE, MN 55044 469-4431 DATE : ~ ~ ~ ' n ; ~G JOB .SITE ADDRESS: / ~ ~ ~C~c~~ PID Fk: LEGAL DESCRIPTION: LOT: BLOCK; SUBDIVISION OR SECTION: X02 T/~~ ,~,t' v APPLICANT: OWNER OR CONTRACTOR (circle one) ` ~ OWNER~OR BUILDER: ~i C~i,r.~~.d C ~ P~~-~, Pte.. PHONE:~~-r~o~ 3 9' .STREET. ADDRESS;.. .S~ ~ ~ CITY: L,.~h'-~v, GL ~ ZIP: S~S'~~ `i'' CONTRACTOR: ~i°~ _?~~`"a~/'CiTY ID NO.:~ PHONE: - ~(~j i STREET ADDRESS: ~ 3 ~~~s ~ ~ ~ CITY: ~~4 h'e'c~ ; GC ZIP: FOR: ~ RESIDENTIAL COMMERCIAL INDUSTRIAL PUBLIC t r TS STREET EXCAVATION NECESSARY? Yes No TO INSTALL: FEf: E. t i SEWER/WATER INSTALL (31) 39.50 + .50 ` fir;., SEWER INSTALL (32) 19.50 + .50 at . WATER INSTALL (33) 19,50 + .50 € <<.,- PRIVATE SEWER (34) 39.50 + .50 L~J- - WELL (35) 39.50.+ .50 ~ PRIVATE SEWER REPAIR (36) 19.50 + ,50 f~; ~ k -SEWER/WATER C0N~lERSION (37) 39.50 + .50 r SEWER CONVERSION (38) 19.50 + .50 • WATER CONVERSION (39) 19.50 + .54 ,s~ r ~fia - 8. _ Al 4 i. ~ ~ - I APPLICANT SIGNATURE: ~ DATE: S~'/~'-~~ i ~r ~ JtWtK HIVU WHItK F'tKl"I1I t'HUt L • ~ y OFFICE USE WORK TYPE INSPECTIONS NEW (81) ROUGH-IN (64) ADDITION (82) FINAL (65) REPAIR (83) (70) DEMOLISH (84) REPLACE..(85) ALTER/REMODEL (86) - MOVE (87) PERMIT-.FEE: PERMIT FEE: $ l SURCHARGE: $ ~ b THER• 0 $ g TOTAL: $ ~d }-O O `I I4 ~I ;.I ',i { i APPROVED BY: DATE: i 6