HomeMy WebLinkAboutNo 14106
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Valuation Water Unit
32r..~~ ~~,.~.I~C3
Clty Of LakG'VI~~2 Bldg. Permit Fee ~ Sewer Unit
State Surcharge 3~.»~~ $ittAreac~~aer,,,, ~.5~.'.)Q
Metro SAC Charge 47` Park Fee .
BUILDING- PERMIT Otherf'~~~.c~7~~'L.... TOTAL PAID......... $~,~12.5C~'
Receipt
Permission is hereby granted to".24t~z1af~ C~n~trvc~~~'
7 a~~dt~ ~'oint:~. 3xi~ G~c33t~an
'Building on Lot No. Block Subdivision
Parcel No. c '-2~3~~2-~~3~7-
in the CITY OF LAKEVILLE to be used as to CCtt28t;C't<Cfr ~in~I ra ~a d~'+ ~ ~ e1.~t 1 i n~•
This permitis'issuedontheexpressconditionthatthe ~ ERECTION ALTERATION REPAIRS
ENLARGEMENT. MOVING DEMOLITION respects to the statements certified. to in the
application for such permit, and that ali 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 fv~l b^`:~.~.~~_~a~ ~~-i~. ia'r-t„~~
Director, Licerise and Inspection
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Callforinspections-4&9-4431. By
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BUILDING PERMIT APPLICATION r
ONE AND TWO FAMILY RESIDENTIAL
CITY OF LAKEVILLE
INSPECTION DEPARTMENT
i 8747 208TH STREET W.
P.O. BOX 957
LAKEVILLE, MN 55044
469-4431
DATE : ~ ~p
JOB SITE ADDRESS: ~p ( ~
LEGAL DESCRIPTION: LOT;__~__ BLOCK:~_ SUBDIVISION OR SECTION; ~
OWNER : t PHONE : ,~jp - 7/~S'r
STREET ADDRESS : CITY : f,~t ZIP : ~ ~
11 r ~ ~ a~
CONTRACTOR: I r PHOgNE: 3 S 3
C~ % (~,•,i - x{31-53.33
STREET ADDRESS: 1l~lo CITY: ZIP: `j
5
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CLASS OF WORK: NEW~~ ADDITION: ALTER/REMODEL: DEMOLISH:
PROPOSED USE (DESCRIBE IN DETAIL):
VALUATION OF WORK (EXCLUDING LAND): a ~
I HEREBY APPLY FOR A BUILDING PERMIT-AND I ACKNOWLEDGE THAT THE INFO&'rIATION
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
Date: Z~, Zone
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Permit Fee $
Plan Check $ ao9 , °y
uildin ffici 's Signature:
Surcharge $J,~ •
Date:
SAC $ 7 ~
Comments:
- - S/W Units $ ~5
Sewer Area $ ~ ~ : L _
Park or Misc. $
s
TOTAL DUE $ - y
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