HomeMy WebLinkAboutNo 13932 "1~ Ait~lt~r ?:3, fit?
Valuation Water Unit
Cit of Lakeville ~€~7,~s~ ~~:~.o~
y Bldg. Permit Fee Sewer Unit
2~.~3~ 'ewer 1~^,t~t3
State Surcharge ~k Area .
Metro SAC Charge ~ • Park Fee .
' BUILDING PERMIT Otnerp~~rj. 2oc~.~~ Tora~ P,e,lo.:::::::: ~~,~~~.r~~
& Receipt
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Permission is hereby granted to
~ BuildingonLotNo. Block ~ Subdivision F~~i_n*~~
ParcerNo. 2~:-~fif~t`~•-I9J^^G~ I
in the CITY OF LAKEVILLEto be used as' ~,~2r1~it 1Rta ccans~xtxct s-tr?~Ie x8ntia.y ~fctell~ri
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 ofi LAKEVILLE, .Minnesota and
the State of Minnesota pertaining to the construction of buildings.
street Address 1~~2"/ ~'XC~1~3.c)r tFirele t~~vid Krin~g
Director, License and Inspection
Call for inspections - 469-4431. By ~ , l
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BUILDING 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: ~
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JOB SITE ADDRESS: " '
LEGAL DESCRIPTION: LOT:~ BLOCK:~_ SUBDIVISION OR SECTION~ca~ /~cn;,4?{
~ OWNER : ` ~ ~~,~Z~~~,~ PHONE : %'Y4/ 7~~
STREET ADDRESS: ~yG/ X? ~ CITY: ~~y ZIP: S~ ~.3~
CONTRACTOR: PHONE:
STREET ADDRESS: CITY: ZIP:
CLASS OF WORK: NEW: ADDITION: ALTER/REMODEL: DEMOLISH:
n t , ~ t~~ ,
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PROPOSED USE (DESCRIBE IN DETAIL) : J ~
VALUATION OF WORK (EXCLUDING LAND):
I HEREBY APPLY FOR A BUILDING PERMIT AND I ACKNOWLEDGE THAT THE INFORl'~IATION
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 PERMITS
AND THAT THE WORK WILL BE IN ACCORDANCE WITH THE APPROVED PLAN.
Applicant's Signature: FOR CITY USE ONLY
~~~j~~~,~~., Date: Zone
Permit Fee $ .
Plan Check $ u~~~
Building Official 's Signature: f
C Surcharge $ 7
-v~~"~.G'- Date: ~ ~ _
SAC $ ~ 1 •
Comments:
S/W Units $ ~ sI
7
Sewer Area $
Park or Misc. $
TOTAL DUE $ .