HomeMy WebLinkAboutNo 14258 _
Valuation ...am =i`'.>"' Water Unit ~2ia_'cr.;
Clty Of LakeVllle Bldg. Permit Fee ~ Sewer Unit ~''t`~
State Surcharge '1{; ~ttArea v=:,'"W.~t'. 3~i7.t~'3
Metro SAC Charge ' ~ - ~t'~ Park Fee .
~ _
BUILDING PERMIT Other ~:s~,~..t::~~~:1~.... }~~~.t1Cl roTAl. PAID.......... ~ ~ ,~t,
Receipt
Permission is hereby granted to ~`ize°~i~+-~1 i'ri~;~*~2 f"dxn~4~~^~rf-in~:
Building on Lot No. Block ~ Subdivision i}nr~~ F.~nt~ '~rc~ t~r}dr _
Parcel No. 22--2~1a~t~o's s ~,`~_.I;l
in the CITY OF LAKEVILLE to be used as ~?~~T'`~ ~A L~' ` `'~'"`~r`~ ~ y~j~-;~~ ~~r'~~~-;~ ~ f ~ ~
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 shalf be done in accordance with the Ordinance of LAKEVILLE, Minnesota and
the State of Minnesota pertaining to the construction of buildings.
Street Address 3 ~ , i'3f'°> ~ r, ~ ,.b,~;
Director, License and Inspection
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Call for ins ections - 469-4431. B A
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BUILLI:VG PERMIT APPLICATION
ONE AND TWO FAMILY RESIDENTIAL
CITY OF LAKEVILLE
~ INSPECTION DEPARTMENT `
8747 208TH STREET W.
P.0. BOX 957
LAKEVILLE, MN 55044
469-4431
DATE :
E
JOB SITE ADDRESS: C~ .
LEGAL DESCRIPTION: LOT:~~ BLOCK: SUBDIVISION OR SECT ION~~~~ ~
~ e~ i'
OWNER : ~ PHONE : y" `~~1~ ~~~-'~i
STREET ADDRESS: ~~~'-\_~c~~r„~„~ CITY: ~.,a~a+-p~,.~~:~~,:~ ZIP: ~~y~~,
h, t~\
CONTRACTOR : s~ PHONE : `~w''a'~-'=~°.~ ~ `~5 ~ - s~
STREET ADDRESS: CITY: ZIP: 1,~^--'
CLASS OF WORK: NEW: ADDITION: ALTER/REMODEL: DEMOLISH;
PROPOSED USE (DESCRIBE IN DETAIL) : ~~~,~'-s~,,,~\
~ ~ ~ T,, ~~~a,~,,.t„
VALUATION OF WORK (EXCLUDING LAND): ~ ~(o
I HEREBY APPLY FOR A BUILDING PERMIT .AND I ACKNOWLEDGE THAT THE INFORIKATION
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 THIS IS NOT A PERMIT AND WORK IS NOT TO START WITHOUT A PERMIT;~
AND THAT THE WORK WILL BE IN ACCORDANCE WITH THE APPROVED PLAN.
Applicant's Signature: FOR CITY USE ONLY
r~ *~.,~~~'l Date:~~~~ Zone
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Permit Fee $ 3s~ -
I' Plan Check $ a 3 ~ . "
Bui ing Off' 1 's Signature:
Surcharge $ ~7.
~~II Date:
SAC $ ~ 7S
j Comments_:_ _
S/W Units $ ~q'~$.
Sewer Area $ p7 `J~(' . ?
Park or Misc. $
TOTAL DUE $ o/L~~ 7 3