HomeMy WebLinkAboutNo 13888 Valuation ~ ! :~:~i . Water Unit . , ~3''t~ _ f elt
Cilt~/ Of Lak2Vl~~@ Bldg. Permit Fee - Sewer Unit ~I'YS . fa€3
State Surcharge -fir - ~t Area . ~AW4'.>~
Metro SAC Charge ~'J ~r . ,~r"~ Park Fee. .
BU1LDlNG PERMiT Otner..~'~.~~t.~4't;~Ctic.. ~t~y~~.€~ TOTAL PAID.......:.^~?~73'7„t~l~,-_
. & Recei pt
-Permission isherebygrantedto r~me~--._ `}'rtc^_
Building on Lot No. 7 Block: ~ Subdivision ~o~lti ~ ;'"lr? A~1•~~l id
Parcel No. ~"•~'+--1"t~
in theClTY OF LAKEVILLEtobeusedas ~'sPYm~ ra n~t•r~g~e•• sir la t•~r~,i ~Y riraal1l'n~
This permit is issued on the express condition that the ~ ERECTION ALTERATION REPAIRS
ENLARGEMENT MOVING DEMOLITION respects to the statements certified. to in the
application for such permit, and that all vrorK shall be done in accordance with the Ordinance of LAKEVLLLE, Minnesota and
the State of Minnesota pertaining to the construction of buildings.
Street Address '+=~celsi.~r I3rive ~ici t' inks
Director, License/and Inspection
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Callforihspections-469-4431. By ~ ---~•-f ' s
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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
DATE.
JOB SITE ADDRESS: ' CQ ~ ~ ,~~~r~l~~{' ~ ~ ~
LEGAL DESCRIPTION: LOT: BLOCK: ~ SUBDIVISION OR SECTION; p~ N j
OWNER: ~,~~,.w.~r-~N(Q. _ PHONE : ~ ~G
STREET ADDRESS: 1~ atURPHY LAKE BLVD.
-T ,ten ~ K~E, MN_ 553T2 C ITY : Z IP
CONTRACTOR: PHONE:
STREET ADDRESS: CITY: ZIP:
CLASS OF WORK: NEW ~ ADDITION: ALTER/REMODEL: DEMOLISH:
PROPOSED USE (DESCRIBE IN DETAIL): ~ ~ ,
VALUATION OF WORK (EXCLUDING LAND):
I HEREBY APPLY FOR A BUILDING PERMIT AND I ACKNOWLEDGE THAT TH ~TFORMATION
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 WITH THE APPROVED PLAN.
FOR CITY USE ONLY
~-Applicant's Signature:
~•v--~Dat e: Zone
Permit Fee $ ~ ~ CrC-}
~ Plan Check $ C' ~ C~
Building Official 's Signature:
- Surcharge $ ~ ~ C
~ rr
SAC $ ~ ~
Comments :
- - S/W Units $ '.1 •
Sewer Area $ .
Park or Misc. $
TOTAL DUE $