HomeMy WebLinkAboutNo 14005 _
G" ~ , 19
Valuation ; , 2 , ; ~ Water Unit 3~~. ~ t:~
Cit of Lakeville Sewer Unit
y Bldg. Permit Fee .
State Surcharge . °~fy ~ Area €.~a~r... 7 ~~i
Metro SAC Charge . ~ ' . C{) Park Fee .
BUILDING PERMIT 'other..~~~~. ~.~b~~ ToTAL PA~o......... nrgt f~
& Receip#
Permission is hereby granted to
Building on Lot No. ~ Block' Subdivision ~'oiv~.t~
Parcel No "'~?3::~.~" £~i" ~1`~~"~.{~2
in the CITY OF LAKEVILLEto be used as p s ti's {`'~"'~at;~`;~^L -~irx~1F' ~ ~~x ~„~r ~tcv~~' itY4~
Thispermiti§issuedontheexpressconditionthatthe ~ 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.
1f~~2 u r',~c~? i~= <,?:v'~ ~~.w ~s' f::, %:a'i,rt.~s
Street Address
Director, License and Inspection
Call forinspections-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.0. BOX 957
LAKEVILLE, MN 55044
469-4431
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DATE: r
JOB SITE ADDRESS: ~
> ST
LEGAL DESCRIPTION: LOT BLOCK: Z-- SUBDIVISION OR SECTION ~Qcl% G//.J t /'L¢~~
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OWNER: G..f ~ C'~iJ 'S
% l~J PHONE : `~J o~ - S .S~
STREET ADDRESS: ~Gj~(p ~~f?D,~Ir~ CITY: ZIP: ~~~L2--
CONTRACTOR : ,~!i j,J,~C~G`~'% S' j c~ PHONE : ~5,.,~ ~3 S~
STREET ADDRESS : 'z'"/~ G(U ~~~iJ G%t ~ CITY : Z IP J /L L
CLASS OF WORK: NEW ADDITION: ALTER/REMODEL: DEMOLISH:
PROPOSED USE DESCRIBE IN DETAIL G ~ ~
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VALUATION OF WORK (EXCLUDING LAND) : ~er~-----~ 3 ~
I HEREBY APPLY FOR A BUILDING PERMIT AND I 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 G]ITH THE APPROVED PLAN.
A icant, s S re: FOR CITY USE ONLY
Date: l 3- Zone
~ Permit Fee $ 3/~ ~
~ Plan Check $ 020 rj • o-D
uilding Of is 's ignature:
_ Surcharge $ ~ ~
Date: '~~~%0
SAC $ ~
Comments:
S/W Units $
Sewer Area _ $ ~
Park or Misc. $
TOTAL DUE $