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HomeMy WebLinkAboutNo 14488 ~ ~ _ + r f ~ ~ 19 Y~ t. l„ Valuation ~ ; ~ . ~ ~ . Water Unit....... . City Of LakOV111E? Bldg. Permit Fee . ' ' • sewer Unit ~ State Surcharge > ~ Street Area . ' ~ Metro SAC Charge Park Fee . . BUILDING PERMIT other....... TOTAL PAID t Recei pt y ~ a 3 s ~r q~ Permission isherebygrantedto ::c~i"~~" ~ ri;~.., -~~r~,:~r `UJ~ -UJ.~.~`,~~ 0~.~.. Building on Lot No, ~ ~ Block Subdivision iiD~d t p~n`.c' S S ~i;F(}--~ aii-'~i ice,.-5 Parcel Np• ~ E ` 'C'EiT?°~.<.Ci: .i~:G ik 1~~3 ^c3tt8~:YL3C4.1.0i:3 f) Sr.t.r3~;~~ ~w,T,3~a.~;--+?tr~"Csi fr ~ i inthe CITY OF LAKEVILLE to be used as J i k ThispermiYisissuedontheexpressconditionthatthe ERECTION ALTERATION REPAIRS ENLARGEMENT MOVING DEMOLITION respects to the statements certified to in the I ~ s ~ application for such permit, and that. all work. shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and i.. - the State. of Minnesota pertaining to the construction of buildings. ~ Street Address t L r' ~ ~V2~ `Y ' Y"lit~ Director, License andlnspection , 1_ :Gall #or in~spe~tions - 469-4431. ~ ~ By . r'~ ~ Li ~ ~ ~ ~ ~ ~ ~ ~ ~v p ~ G -J ~ ~ m ~ ~ ~ ~ ~ ~ ~ ~ ~b ~I ~ ~ ~1 fi i 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 r DATE : _ -JOB SITE ADDRESS: ~ LEGAL DESCRIPTION: LOT: f~ BLOCK:~_ SUBDIVISION OR SECTION; ..~~~~~%'~T~ OWNER: PHONE: ~ S^O D ~ STREET ADDRESS: ~ CITY: ~~_;~~.~~P.ZIP: ~"~1l CONTRACTOR: PHONE: STREET ADDRESS: CITY: ZIP: CLASS OF WORK: NEW= ADDITION: ALTER/REMODEL:~,'~`~ DEMOLISH: r , /~i _ ~ 9 PROPOSED USE (DESCRIBE IN DETAIL) : ~ two.-~~ ~ C. l ~ % t = - ~i ~ % VALUATION OF WORK (EXCLUDING LAND): ~ ~ I HEREBY APPLY FOR A BUILDING PERMIT AND I ACKNOWLEDGE THAT THE INFOR1rIATION ABOVE IS COMPLETE AND ACCURATE;. THAT THE WORK WILL BE IN CONFORMANCE WITH THE -0RDINANCES AND CODES OF THE CITY AND WITH THE STATE BUILDING CODE, THAT I t7NDERSTAND 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 Applicant's Signature: Dates -Y ~ - Zone Permit Fee $ ~ Plan Check $ Building Official 's .Signature: Surcharge $ ~ • S~ Date: .SAC $ Comments: S/W Units $ Sewer Area $ i Park or Misc. $ TOTAL DUE $ ~ ~ • ~C~ i