HomeMy WebLinkAboutNo 14023
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Valuation ~i ~~S - il(l Water Unit .
Clty Of L.ak@V711e Bldg. Permit Fee 1 ~ - Sewer Unit
State Surcharge - 517 StreetArea
Metro SAC Charge Park Fee .
BUILDING PERMIT Other TOTAL PAID......... ~1•~..~U
Receipt
Permission is hereby granted to ~r~~~s"'" I}alton tiiT7^£Y"
Building on Lot No. ~ Block Subdivision :Pc~x~t~
~ Parcel No. z~ ~nn~~ alt
in theClTY OF LAKEVILLEtobeusedas,~~~~~ ['fT~l~br',Ctil.r'"t stos~ste
This permitisissuedontheexpressconditionthatthe 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 Siate of Minnesota pertaining to the construction of buildings.
Street Address lfirt~i4 ~'~r~:~14 t}r ~ ~€re `~;~.yid ~e tC~:La?~s
Director, Licenseand Inspection
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Call for inspections - 469-4431. BY ~'*~s~ ~ '
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~ ~ BUILDING PERMIT APPLICATION
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ONE AND TWO FAMILY RESIDENTIAL
~ CITY OF LAKEVILLE
INSPECTION DEPARTMENT
8747 208TH STREET W.
P.0. BOX 957
' LAKEVILLE, MN 55044
469-4431
DATE:
JOB SITE ADDRESS : ~ ~ ~ ~ t ScS~ ~
LEGAL DESCRIPTION: LOT; BLOCK: SUBDIVISION OR SECTION: 77
OWNER: ve pv ~ `~~I~~ PHONE: ~ ~~~JQ
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STREET ADDRESS : L ~C3 S .S ~'K~ ~i s ~ C ITY : Z IP : ,j S~O Co ~
CONTRACTOR: PHONE: L..,
STREET ADDRESS: CITY: ZIP:
CLASS OF-WORK: NEW: ADDITION: ALTER/REMODEL: DEMOLISH:
PROPOSED USE (DESCRIBE IN DETAIL): a~"
~~y ~ •
VALUATION OF WORK (EXCLUDING LAND): -icy
I HEREBY APPLY FOR A BUILDING PERMIT AND I ACKNOWLEDGE THAT THE INFORMATION
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 GIITH THE APPROVED PLAN.
Applicant's Signature: FOR CITY USE ONLY
Date: ~ C(- s~ Zone ~JA
Permit Fee $ ~ ~J' ~ ~ q~~g~
Plan Check $
Building fficial 's Signature:
Surcharge $ . `J' ~
Date: /
SAC $
Comments:
" - S/W Units $
~ Sewer Area $
Park or Misc. $
TOTAL DUE $
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