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Valuation f2,'`?f,'~~ Water Unit............. ~"r."~
Clty Of L1k2V1112 Bldg. Permit Fee ' { `'3 • Sewer Unit........... >
State Surcharge ~ • I?~ 2S3Fi~ Area . .:`.1{}
Metro 5AC Charge ~ • '=.i~} Park Fee .
BUILDING PERMIT other TOTAL PAID....:: ..~~s~~~=~•'~
Receipt
.
Permission is hereby granted to ~>t'~kL~1i "crrs~tt' ~a , T~i~
Building on Lot No. Block Subdivision ?F.i~f~t~'~ 1'c~rtr+ ~i~3 a~
t'4~
Parcel No. n?_'?+1a~,>_.~,c~~;_~,.?
in theClTY OF LAKEVILLEtobeusedas ~pz~~- t:~ CCd?i'.?f`~,,;Ct s~_n[~7.C f~~~~i.ly ~t~~7.1i.7<+;
This permit is issued ontheexpressconditionthatthe 't ERECTION ALTERATION REPAIRS
I ~ 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 of buildings.
Street Address ~-~a_":; ~ " "a"te ~ x" ° ~,Y Y o. ~ ' ~~i ~ 1 ~
Director, License and Inspection.
Callforinspections-469-4431. BYE, ~ `
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_ ~ APPLICATION FOR BUILDING P~MIT CITY OF LAKEPILLE
8747 208th St. W,, P.O,Box 957
• Lakeville,. rirt 55044
(612) 469-4431
Job Site Address ~X~~ ~S I O j" ~G~L4
Legal Description: Lot Block ~ Addition
Owner Phone
Address P.O.Box:
City. Zip
Contractor f~ / L ~1~~,~~- ~ ~ j ~ j ~
Phone ~t _ C~C2~ .'7`
Address ~ ~ P.O.Box: -r o
City _ ~ ~1~ Zip
Class of Work: %~Erect ( ) Alter ( ) Repair ( ) Enlarge ( } *iove ( ) Demolish
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Proposed Use (Describe in Detail) E~.re'c:~~,~
. Commercial: Square Feet ~ '~//']~5~~ ~ Employees
w -
Heating Contractor ~ '
Plumbing Contractor ~ I t ~ ~ ~
Sewer & Water Contractor I A '
Electrical Contractor _ p ~ ~ ~ ~
Special Condi ions
Valuation of Work: $ ~ Y~
' FOR CIT° USE ONLY
'Signature of Applicant ~ Title:
City Fee $
~ a
Place Check $ ~ ,
Date Surcharge $ _ c~ 1 J^
~Z 3
sAC
Signature of Zoning Officer:
I ~y
~'i ~ SfW Units $ ~
I~ Sewer Area $ '
Date
~ Street Area $
Signature of Building Official:
Park or Misc. $
Total $ .5", ~ 4
Date:
SID MILLER, BUILDING INSPECTOR