HomeMy WebLinkAboutNo 13897 I
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Valuation 5~~,'~'`_'~.D`1 Water Unit } s3Tt7C3
City of Lakevi t e` Bldg. Permit Fee ~ • Sewer unit ~sC35 , ~0
State Surcharge • ~t Area ...~~x. ~
Metro SAC Charge =k7 ~ - Park Fee . . .
.BUILDING PERMIT Other..~'1~'3fl..c.u~~.:~.. 2f3'3-!?~ TOTAL PAID.........~~•~~~•~~ 1
& Receipt
Permission. is hereby granted to Z~c
~ Building on Lot No. ~ Bfocic 1 Subdivision Dodgy
~ Parcel No. 22 C}Fit~ i71
in the CITY OF LAKEVILLE to be used as ~~'rn3.t< t0 C*aA>~tY'~lCt Si>:t~3~ family.. t~~a~113.ng
This permit is issued on the express condition that the ERECTION ALTERATION REPAIRS
ENLARGEMENT MOVING y,,s-- 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 LAKEVLLLE, Minnesota and
the State of Minnesota pertaining to the construction ofbuildings.
streetAadress l~lp3 ~xcei~io;. iyxivc~ ~lavid. P, Krin~.t
Director,Licenseand Inspection
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Cailforinspections - 469-4431. BY
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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: ~ ~
JOB SITE ADDRESS: ~ b` O~
p,~( ~'a ~ d+ 7`e / s 7
LEGAL DESCRIPTION: LOT: BLOCK: ~ SUBDIVISION OR SECTION; ~c~c(~~~1~~ ~ ,(~,b~q~~ eo,
OWNER: y S'~~r.~~---, C7~r.--~~~ PHONE• F~
STREET ADDRESS: ` CITY: ZIP:
CONTRACTOR: G; ~¢~c/~ .~'~-j c, PHONE: ~.~3 ~-5~y-~
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STREET ADDRESS: / s`sr3 ~i' ?Y-9L So CITY: ~ur.~.a--s'~. ZIP• .55 3 ~ ~
CLASS OF WORK: NEW ~ ADDITION: ALTER/REMODEL: / DEMOLISH:
PROPOSED USE (DESCRIBE IN DETAIL) : S~1.~~/ < ~~-rl ~
tr~
~ VALUATION OF WORK (EXCLUDING LAND):
I HEREBY APPLY FOR A BUILDING PERMIT AND I ACKNOWLEDGE HAT 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 PERMITS
AND THAT THE WORK WILL BE IN ACCORDANCE GIITH THE APPROVED PLAN.
Applicant's Signature: - FOR CITY USE ONLY
Date: ~ O ca Zone c ~C+
Permit Fee $ ~ I ~
Plan Check $ oCD 3 •
Building Official 's Signature:
Surcharge $ ~C7 -
Date: ~
SAC $ ~ 7~•
Comments
S/W Units $ / ~'02~• -
Sewer Area $ ~ 5 ~
Park or Misc. $
TOTAL DUE $ ~ ~ Yr C
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