HomeMy WebLinkAboutNo 13628 ,r. ~ ."zur~ a ~ 19 ~6
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Valuation l l ',r~ _ Water Unit €~7_i° .'_3[~
Clt)/ Of Lak2Vllle Bldg. Permit Fee ~~~y Sewer Unit ~~1~ '~t~'
State Surcharge ~ ~ $ttArea. ~t?T~t~~:.. 7~,fl.€113
Metro SAC Charge ~ - Park Fee .
BUILDING PERMIT other ..~l:~z>,.4~~ck:.. ;?t;~3_il?') TOTAL PAID.........-S7~j l?_4113..
& Receipt
Permission is hereby granted to ~:oz:~t;xuct~~n
' Building on Lot No, ~ ~ Block ~ Subdivision
...Parcel No. ~ 2-2~~b~m ~ ~ 1.3-°+l .t
in theClTY OF LAKEVILLEtobeusedas J~I'm1rt; t:rs ' ~vi~ irt• ~in~Tls~ #~atni7~ :,~+°,al'{n
Thispermitisissuedontheexpressconditionthatthe ~ ERECTION ALTERATION REPAIRS
G
M ENLARGEMENT MOVING DEMOLITION respects to the statements certified to in .the
application for such permit, and that all work shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and
the State of Minnesota pertaining to the construction of buildings.
StreefAddress l.~~IJ i E~c>~°.,.> •rve 'i~-~*fri rz ~~riv~t~~
Director, License and Inspection
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CaII for inspections - 469-4431. BY ^t
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BUILDING PERMIT APPLICATION
ONE AND TWO FAMILY RESIDENTIAL
CITY OF LAKEVILLE
INSPECTION DEPARTMENT
8747 208TH STREET W.
P.0. BOX 957
LAKEVILLE, MN 55044
469-4431
DATE : ~ / ~j~(~(/
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JOB SITE ADDRESS: ~lp/~~ I-'~X(°,~=%,~/OR ~.P~U~
LEGAL DESCRIPTION: LOT: /I BLOCK: SUBDIVISION OR SECTION:L~/~/ti~/~% ~ ~,o,~e
OWNER: C-~i9yir~ S7 % ~~,G ~ PHONE : ~-~~S®
STREET ADDRESS : j~~ P/moo/SL~~=l!.GC. ,~tt. - CITY : ~/~A t~~f~ N ZIP : ~
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CONTRACTOR : / ~ jTsc.NL~e is T.E'uG7'i U%-~ PHONE : ,l/$~
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STREET ADDRESS : ~~~lc Q/~'/g~ fig/~~S f CITY : y~,?~tJ ZIP : ~S/a2,`~..
CLASS OF WORK: NEW: ADDITION: ALTER/REMODEL: DEMOLISH:
PROPOSED USE (DESCRIBE IN DETAIL) : S/ ~h,,r~I~
VALUATION OF WORK (EXCLUDING LAND) ~
~D ~ pro.---=-
I HEREBY APPLY FOR A BUILDING PERMIT AND Y~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 PERMITS.
AND THAT THE WORK WILL BE IN ACCORDANCE WITH THE APPROVED PLAN.
Applicant's Signature: FOR CITY USE ONLY
.rl Date: ~.2 Zone
Permit Fee $ . ~
Plan Check $ c~ ~ ~ «'D C'~~~"
Building Official 's Signature:
Surcharge $ ~f U'~ (p I a~gb
Date: ~1~
SAC $ ~ ~ ~ . y~
Comments:
- - S/W Units $ ~ ~f~~~ .
Sewer Area $
Park or Misc. $
TOTAL DUE ~ ~ ~
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