HomeMy WebLinkAboutNo 14422 ..,q~~Gl=. ~ ~ ~ 19 ~7
Valuation ~ ~ ~J4? . ,Water Unit €320 •
Cil ty Of Lak@VI I Ie iBldg. Permit Fee ~ • `~0 Sewer Unit • 00
State Surcharge ~>~.~0 ~rArea.~~"~~~~... 2~~.~~
Metro SAC Charge s5 ~ ~ • Op Park Fee . . .
BUILDING PERMIT other .:~.r.~X2..~'e'tt.~~~.. il~.~le~ TOTAL PAID.. $2.7a~'.~f~
Receipt
Permission is hereby granted to f;~t18 t1"U G ~ ~.GT1 t~:? .
Building on Lot No. ~ ~ Block ~ Subdivision.. jt~dc3 ~.''OiTltE". `3rd Aclditio~A
Parcel No. 22--~t~£3t~2_110_
in theClTY OF LAKEVILLEtobeusedas De~°rsait to CGl~3s~T'i1GC sin~l~ ~a~?ily ~w~~.l":,rtS_"
This permit is issued on theexpresscondition that the ~ ERECTION ALTERATION REPAIRS
ENLARCaEMENT 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:
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Street Address
Director, L~nseand Inspection
Calfforinspections--469-4431. By s ~ ~ ! ' / f
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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
DATE :
JOB SITE ADDRESS: C~~~~ _ G~
LEGAL DESCRIPTION: ~ LOT: BLOCK: - SUBDIVISION OR SECTION:JJ~4~~ o/N?e 3--~
OWNER: SG/J.T 1. G,i1S7`~L~~;T/v <J Wit/ PHONE: ~S s
STREET ADDRESS: `7 ~ll~ /,~-~~'/J~~c~ ~~h CITY: ~.~~~}/J ZIP: S
S ~Z
CONTRACTOR: SfiNS` ~®,rf.s~~2.c,,..~-riu~r 4~ PHONE: `TS a ~ , 3 S.J~
STREET ADDRESS : ~ G ~ ~ G- ~ /J ~ ~i e. CITY : G ~ ~-,a ~ ZIP : S ~I ~ z-
.CLASS OF WORK: NEW: ADDITION: ALTER/REMODEL: DEMOLISH:
PROPOSED USE. (DESCRIBE IN DETAIL) : ~/O/y
fJ
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VALUATION OF WORK (EXCLUDING LAND): ti ~ ~V ~
I HEREBY APPLY FOR A BUILDING PERMIT AND I ACKNO EDGE THAT THE INFORMATION ~
ABOVE IS COMPLETE AND ACCURATE; THAT THE WORK WILL BE IN CONFORMANCE WITH
THE ORDINANCES AND CODES -0F THE CITY AND WITH THE STATE BUILDING CODE:; THAT
I UNDERSTAND THIS IS NOT A PERMIT AND WORK IS NOT TO START WITHOUT A PERMITp
AND THAT THE WORK WILL BE IN ACCORDANCE WITH. THE APPROVED PLAN.
A cant' S"g atur FOR CITY USE ONLY
Lam. Dater J - S , ~ Zone
- Permit Fee $ ~ 5S .
.Plan Check $ 1
Bu' ding Offic' 1 's Signature:
Surcharge $ pZ"[ .c~
Date:
SAG $ SoZS
Comments : ,t
S/W Units $ ~Te~s
Sewer Area $ L~
Park or Misc. $
TOTAL DUE $ c~