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HomeMy WebLinkAboutNo 14205 1 _ 19 a, ~ Valuation Water Unit . , . Clty Of Lak@VI ~ ~2 $Idg: Permit Fee , ' Sewer Unit . ` ' . State Surcharge Str.Area i .'i::... ~ MetraSAGCharge • • • • • • . Park Fee Other . s ` TOTAL PAID - BUILDING PERMIT . ~ & Receipt ~ , Permission is hereby granted to - ~c t: ' T ~~5~ ~ ~ ~ Building on Lot No. Block ~ Subdivision ' h: - Parcel No. ~t ' in the CITY OF LAKEVILLE to be used as ~ xi,, .r a i' t °;r ~ ~ This permit is issued on the expressconditionthatthe ERECTION ALTERATION. REPAIRS ENLARGEMENT 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 ofi build'++ngs. . ; „ , StreetAddr~ - ~ _ 'o~ t~ 4~:~~r - Director, License and Inspection r- Call for inspections-469-4431. lay T- ` ~ ~ ~ 1f ~ ~ ~ ~0 ~ ~ ~ 0~ ~ ~ ~ ~ ~ ~ ~ oc, ~ ~ ~ ~ ~ ~ V N ~ ~ - ~ ~ ~ ~ b ~ ~ ~ o ~ ~ A ~ ~ fit-- -°0 0 ~ A ~ L © ~ ~ ~ ~ C~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ R ~ ~ > ' ~ ~ ~ ~ ~ ~ r ~ 9 ~ ~ ~ ~ o _ F ~ ~ ~ BUILDING PERMIT APPLICATION ONE AND TWO FAMILY RESIDENTIAL ~ ~ ~~y1-a~~~, CITY OF LAKEVILLE ' INSPECTION DEPARTMENT - 8747 208TH STREET W. P.0. BOX 957 LAKEVILLE, MN 55044 469-4431 DATE : ~ f ~ - S ~ ~G% C~~ a I<-- JOB SITE ADDRESS : ~ ~ ~ ~ ~i,?,h , cam, LEGAL DESCRIPTION: LOT:~ BLOCK: A SUBDIVISION OR SECTION: ~'~c/'/~ ~Gj~~ r° ~ PHONE: ~~<1 ~ OWNER: ~ _ ~ ~ S . ;/z-~~N i ~„a ~ _ ~ t~ STREET ADDRESS:'~I~w L~r~~~la-~` k'_~ CITY: ~~C~-;d ZIP: S~~ ~z~ CONTRACTOR: ~a h~_>> ~i ~ ; j~ PHONE: jZ ~ f" STREET ADDRESS : 7 l ~ ~ r ~ CITY : C/~(9./~ i~ ZIP : J t__ CLASS OF WORK: NEW: ADDITION: ALTER/REMODEL: DEMOLISH: PROPOSED USE DESCRIBE IN DETAIL) : ~~~L~- c..~,1 ~ d„ e VALUATION OF WORK (EXCLUDING LAND): J,~'-/ I HEREBY APPLY FOR A BUILDING PERMIT AND I ACKNOWLEDGE THAT THE INFORPIATION 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 n~'' I UNDERSTAND THIS IS NOT A PERMIT AND WORK IS NOT TO START WITHOUT A PERMITS \ ~ AND THAT THE WORK WILL BE IN ACCORDANCE G1ITH THE APPROVED PLAN . `~P \p'~~11ay ~~plica 's '~ature: FOR CITY USE ONLY ~ a Zone ~ Q Ig4~ ,~:r.~ Date: 2 '7 c- ( ~~Q~j Permit Fee $ ~7oc ~7 '~"E ~ ' Plan Check $ ~ f 1 : ~ Bui ing Offi i 1 's Signature: ~~~~~c,~, Surcharge $ • ~r • Date: ~ SAC $ ~ 7~• Comments : _ S/W Units $ a~ Sewer Area $ ~ • Park or Misc. $ TOTAL DUE $ ~ ~ 1 O • i