HomeMy WebLinkAboutNo 14358 ~ 3 ~ 19
Valuation l=7sL`~?~).1~ Wate`rUnit :3:~{~.'"):
Clty Of Lak@VI~~@ Bldg. Permit Fee ;i'3I «r~+.} Sewer Unit . ii'~`ry . vfJ
.~r'Ft`l r t~.i.j r~s+~ ? ~itl , f~.a'.i
State Surcharge.......... ~4Area
Metro SAC Charge ~ » Park Fee . .
BUILDING PERMIT Otner....~'~-~?t ~Yt~, TOTAL PAID..
Receipt
Permission is hereby granted to
Building on Lot No: Block Subdivision ~c~it~i. e1_~~:~.~~.c)a
Parcel No. 22 Zi7,"'s4~ ~.--1.;7~'~~-Ui
in the CITY OF LAKEVILLE to be used as yWt`trtlt .:~"lS~X'tt::L` S1t1~;3 a ikitZ't~?.~ dx~ei?
Thispermitisissuedontheexpressconditionthatthe ERECTION ALTERATION. REPAIRS
ENLARGEMENT MOVING DEMOLITION respects to the statements certified to ih the
application for such permit, and that alf'work shalt be done in accordance with the Ordinance of LAKEVILLE, Minnesota and
the State of Minnesota pertaining to the construction of buildings.
Street Address 1~u~Z ~~~~~~lr,~ :.tx'lyP ?.?~Yr1i~ i~:.t:'t?.~;6
Director, License and Inspection
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Call for inspections-469-4431. By~,. • ~ ~=T(~ ~ f -
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BUILDING PERMIT APPLICATION
ONE AND TWO FAMILY RESIDENTIAL
CITY OF LAKEVILLE '
INSPECTION DEPARTMENT
8747 208TH STREET W.
P.Q. BOX 957
LAKEVILLE, MN 55044
4b9-4431 ~
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DATE : o~ f ~ b' _
JOB SITE ADDRESS: ~ t
LEGAL DESCRIPTION: LOT: l~ BLOCK: SUBDIVISION OR SECTION; ~'~,ri'~
OWNER : ~ i; C L? ~ PHONE : ~ ~ 01 ~ 1
STREET ADDRESS: _(o ) ~ ~ ~ ~ j ~ J CITY: -~Q~pL~ y/ ZIP:
CONTRACTOR: _ ~ w n/ ~ PHONE:
STREET ADDRESS: CITY: ZIP:
CLASS OF WORK: NEW: ADDITION: ALTER/REMODEL: DEMOLISH:
PROPOSED USE (DESCRIBE IN DETAIL):.
VALUATION OF WORK (EXCLUDING. LAND) : f„ ~ Z7 ~5 (ooC
I HEREBY APPLY FOR A BUILDING PERMIT AND I ACKNO EDGE THAT THE INFORiyfATION
ABOVE IS COMPLETE AND ACCURATE; THAT THE WORK WILL BE IN CONFORMANCE WITH
THE ORDINANCES AND CODES OF THE CITY AND WITH TH$ STATE BUILDING CODE, THAT
I UNDERSTAND THIS IS NOT A PERMIT AND. WORK IS NOT TO START WITHOUT A PERMIT;
AND THAT THE WORK WILL BE IN ACCORDANCE. WITH THE APPROVED PLAN.
Applicant's Signature: FOR CITY USE ONLY
../l.~?.`~ 1~-1 Date: C}~ ~ ,l ~ ~ Zone
Permit Fee $ V c~~ •Jr0
.Plan Check _ $ ~ 3 3
Building Offic'al 's Signature:
U Surcharge $ ~ g .
Date. ^-/~/_Q? _
o[_
SAC $ S oZ `J .
Comments:
S/W 'Units $ ~ 4 . "
Sewer Area $
Par
k or Misc. $
TOTAL DUE _ $ `l D o~Z • SO r®'