HomeMy WebLinkAboutNo 13698 {
Q y,. ,
.T~tncz t'> ~ 1g X36
~ ~
Valuation ~ 1 _ ~f4 Water Unit ri2f~ _ ~3C
Cilt~/ Of Lak@VI I I2 Bldg. Permit Fee 'R!~~ _ s's'a .Sewer Unit Fi - I:
{n
State Surcharge '1~ - t~C1 ~t Area .`$~zze~ 25.[3.
Metro SAC Charge G 7 ~ _ :'tt'i Park Fee .
BUILDING PERMIT Qther..~?~.,~x~.~'i~~j;.. TOTAL PAID.........~S~f7L~5,(~_
& Receipt
Permission is hereby granted to ~~~~~'<s~.~. ~3u3.lde~
Building on Lot No. ~ Block ~ Subdivision ~'c~a.nte
Parcel No. 2~-2flf35E3«~~31fl-~~
in the CITY OF LAKEVILLE to be used as ~ertrit• r_An~t*~t~~ t ~~~~-~y xri~
This permit is issued ontheexpressconditionthatthe ~ ERECTION ALTERATION REPAIRS
ENLARGEMENT MOVING .DEMOLITION respects to the statements certified to in 4he
application: for such permit, and .that all work shall be done in accordance with the Ordinance of :LAKEVILLE; Mihnesota and.
the State of Minnesota pertaining to the construction of buildings.
Street Address lE~(36t~ ~xc~l~:~s~r '?riUe' 3~awir~ r. ~:r.in~
Director, License and Inspection
~
Call for inspections - 469-4431. By ~
1
S
~ ~1
~
l° ~ 4"?~
o ~ ~
~ ~ ~ ~
GCl `~~1'
I' ~ L
r~ _
BUILDING 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 : ~ ~
1
JOB SITE ADDRESS : ~ ~ ~~1 ~ ,
LEGAL DESCRIPTION: LOT:~ BLOCK: Z`' SUBDIVISION OR SECTIOI~T: f'U(~!~ Jt
1
~ s
OWNER : 1~u j'~ PHONE
STREET ADDRESS: ,.~~~''fs~L`?` CITY: ~y~'"""~~ ZIP:
CONTRACTOR: 't'° Y'~ e ~ v'y Y/ ~ I V~' "'~i PHONE: ~"1 3 3° ' ~
STREET ADDRESS: CITY:. ZIP:
t/"
CLASS OF WORK: NEW: ADDITION: ALTER/REMODEL: DEMOLISH:
PROPOSED USE (DESCRIBE IN DETAIL) : f=~ /c~'
VALUATION OF WORK (EXCLUDING LAND): •
I HEREBY APPLY FOR A BUILDING PERMIT AND I~ CK~O E E THAT THE INFO&'~SATION
ABOVE IS COMPLETE AND ACCURATE; THAT THE WORK WILL BE IN CONFORMANCE WITH
THE OP~DINANCES 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.
FOR CITY USE ONLY
licant's Signa u e: pp c~
1~"` Date: ~ 1 Zone
Permit Fee $ ~ • G~
Plan Check $
Building Official `s Signature:
/ Surcharge $
i/ Date:
SAC $ ~
Comments: <
-
S/W Units $ J ~f Gr'`~
Sewer Area $
Park or Misc. $
TOTAL DUE $