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' Valuation ''"~,!~B~-~Sr Water Unit
y Of LaICeVllle Bldg. Permit Fee • Sewer unit,........... ` '-1 • r~'
State Surcharge 2 ? r,, ~z Sfi~~Area . ~~?~~Jr ?.i%? .
Metro SAC Charge • Park Fee .
BUILDING PERMIT other. ta~.~~..cY~c-~.. TOTAL PAID.. ~~~~i9~•`~~
& Receipt
Permission is hereby granted to Gt~ta~~~uckaoxz
Building on Lot No. 13 Block ~ Subdivision i~?(3!~~ £'oi~Tt
Parcel No. 2' ~ `l'~ 1 3~~-t'~ l
in the CITY OF LAKEVILLEtobe used as pe~r~ait t:~ C='~`7:stYt~c=~~ ~in~*~i~ f~mil.y d~;1~e? 3.~z~`''~
Thispermitisissuedontheexpressconditionthatthe 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
Director, License and Inspection
1
~ Call for inspections - 469-4431. ` By f -
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CITY OE LAKEPILZE
APPLICATION FOR BiTILDING PE?~'iIT
,~,U~%~ 8747 208th SC. W. , P.O.Box 957
Lakeville,. MN 55044
~ ~ ~ ~y ~ (6I2) 469-4431
Job Site Address r
Legal Description: Lot Block f Addition -~~~1~LU~~_~~_ .
Owner Phone
Address P.O.Box:
City Zip
Contractor Phone C~~"' ? 4-3 t -
Address ~7/ ~?.h ~ City ox: Zi 7
p
Class of Work: Erect ( ) Alter ( ) Repair ( ) Enlarge ( ) '_•iove ( ) Demolish
Proposed Use (Desc ibe in Detail)
Commercial: Square Feet ~ Employees
Heating Contractor
Plumbing Contractor
Sewer & Water Contractor
Electrical Contractor
Special Conditions ~-~~~~e;
Valuation of Work: $ T
" FOR CITY USE ONLY
Signature of Applicant b Title:
City Fee $ _
Plan Check $
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~ , -
Date ~ _ ~ 5•~~' Surcharge - $ _ ,v ~ . ~
SAC $ !1' Y ,
Signature of Zoning Officer:
~ •
. S/W Units $ ~~V~ ~
Date Sewer Area $ _ C~
Signature of Building Official: Street Area $
Park or Misc. $
Date: Total $ ~at.. w
SID MILLER, BUILDL'~IG INSPECTOR