HomeMy WebLinkAboutNo 14488 ~ ~
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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
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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
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k ThispermiYisissuedontheexpressconditionthatthe ERECTION ALTERATION REPAIRS
ENLARGEMENT MOVING DEMOLITION respects to the statements certified to in the
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~ application for such permit, and that. all work. shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and
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the State. of Minnesota pertaining to the construction of buildings.
~ Street Address t L r' ~ ~V2~ `Y ' Y"lit~
Director, License andlnspection
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:Gall #or in~spe~tions - 469-4431. ~ ~ By . r'~ ~
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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
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:
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PROPOSED USE (DESCRIBE IN DETAIL) : ~ two.-~~ ~ C. l ~ % t = - ~i
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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 $
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Park or Misc. $
TOTAL DUE $ ~ ~ • ~C~
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