HomeMy WebLinkAboutNo 13995
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_ Valuation Water Unit R7t1,f1'~
Clty Of Lak@VI~~@ BId~,-Permit Fee . 31{3'.!~Cl Sewer Unit ht35 _ ft(3
StateSurcharge 2'~.5~3 ~tArea..S~w~r... ~~~-fly l
Metro .SAC Charge E~75sf.7Cl Park Fee
BUILDING PERMIT Other:~~a .~~?~clf:... TOTAL PAID.........~~~..,~91_t~t?
& Receipt
Permission is hereby granted to "'"'E'A'C'I ~P I2PV~~t?~faT'S
Building on Lot No. Block ~ Subdivision ~fc~~~ ~nintr~
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Parcel No, 2`? '3i~f7(St? li}•a
rm-ti *tt r~r ts~fir°tc t 'a~in~ a ~~zr~~ 1 ct~rall 3~~~
in the CITY OF LAKEVILLE to be used as ~ ~ ~ ~
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 of buildings.
Street Address f~]~~ I'xcb ~'fc7~C r~~~az`t ''~at,i; F'r-4;~~rc
Director, License and Inspection
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Call for inspections - 469-4431. BY ~ ,i. H 1` ` `'t ~ }
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BUT:I,DING PERMIT APPLICATION
ONE AND TWO FAMILY RESIDENTIAL
CITY OF LAKEVILLE
~ INSPECTION DEPARTMENT
8747 208TH STREET W.
P.O. BOX 957
LAKEVILLE, MN 55044
469-4431
DATE: ~ ~ ~(p lLI°Z
JOB SITE ADDRESS: ~ S~ ~
LEGAL DESCRIPTION: LOT: BLOCK:c~ SUBDIVISION OR SECTION; ~ ~ ,
OWNER: _ PHONE :
STREET ADDRESS : ~ CITY : ~ -~nS~ ~ Z IP : t~~J
CONTRACTOR: PHONE:
STREET ADDRESS: CITY: ZIP:
CLASS OF WORK: NEW ~ ADDITION: ALTER/REMODEL: DEMOLISH:
PROPOSED USE. (DESCRIBE IN DETAIL) : ~.yr",~ C3"u ~`~1~Io
T1` ~ 4
VALUATION OF WORK (EXCLUDING LAND): D oZ C7
~T
I HEREBY APPLY FOR A BUILDING PERMIT AND I ACKNOWLEDGE THAT THE INFORI~L4TION
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 ACCO DANCE G1ITH THE APPROVED PLAN.
Ap li ' nature: FOR CITY USE ONLY
Date: ~ ` Zone
Permit Fee $ ~6 C/
Plan Check $ •
Buil ing Official 's Signature: .~Q
- ~ Surcharge $ ~ 7
Date:
SAC $
Comments_•_ S/W Units $ /`"t' o~:~
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Sewer Area $
Park or Misc. $
TOTAL DUE $ -
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