HomeMy WebLinkAboutNo 14505 a ? 4
J
v
Valuation ~ ~ c n., Water Unit
-~vcr.
CItY Of LakeVlF~@ Bldg. Permit l=ee ~c Sewer Unit ts8~@~
State Surcharge , ~ z n2 Sir ~t Area •c~~'uy~
` Metro SAC Charge fC 2L. nn Park Fee .
BUILDING PERMIT other ,~~.~t~•~~i~~k.. ToTA~ PAIO.........~-~-~---(
Receip
Permission is hereby granted to '
Buildingon LoTNo. ~ Block 1~„? Subdivision ~
Parcel No. -
in the CITY,OF LAKEVILLE to be used as .
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 work shall be done in accordance with the Ordinance of ~AKEVILLE, Minnesota and
the State of Minnesota pertaining to the construction of buildings.
Street Address ~6~9(l Fa->r~rc~an v~rn~g '
Director; License nd Inspection
Call for inspections - 469-4431. BY ' '
f
i
_ - I
w• ~I
S ~
~ ~
~ ~ ~ ~
~ ~
c~
~ ~ ~ ~
c~ c~ ~T~
r- r-
~ ~
~ ~
II
ONE.AND TWO•FAMILY RESIDENTIAL • i
CITY OF LAKEVILLE
INSPECTION DEPARTMENT ti
8747 208TH STREET W.
P.0. BOX 957
LAKEVILLE. MN 55044
469-4431
DATE: ~ / ml~-°'
JOB SITE ADDRESS: / ^ t t~'c1~G'- `-'7`--''
LECAL DESCRIPTION: LOT: BLOCK:'f~ SUBDIVISION OR SECTION; y [,.%-~L..-
OWNER: PRONE:
STREET ADDRESS : / yy~ ~y~,~ ~ / CITY : Q ZIP
CONTRACTOR: ,y~ i / ~ (..[.L~~.-C~f'Z--1 ~~}'7'7~~ Pt30NE: a
STREET ADDRESS : / 3 ~ t.-~~~1~'~ ~'ti`~`~~ CITY : ~.k`G~,~72G'y? ' ZIP :
CLASS OF WORK: NEW ~ ADDITION: ALTER/REMODEL: DEMOLISH:
PROPOSED USE (DESCRIBE _IN DETAIL): ~y `r~ ~
1.
VALUATION OF WORK (EXCLUDING LAND}: r~ T
R ) ~ ~ r
f
I HEREBY APPLY FORA BUILDING PERIiIT AND I ACKNOWLEDGE THAT THE INFORMATION
ABOVE IS COMPLETE AND ACCURATE; THAT THE WC3RK WILL BE IN CONFORMANCE WITH ~ ,OI~~
THE ORDINANCES AND CODES OF THE CTTY AND WITH THE 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.
FOR CITY USE ONLY
Applicant's Signature:
r
Permit Fee $ ~
lan Che`ck` S
Building ¢f icial 's Signature:
~ / Surcharge $ , _
/
/J'.~-rf Dace: SAC $ ~ K'' C" C~
r
Comments: gJW Units S t/
"
~A
~-r r.
Sewer Area S G.
Park or Misc. S
TOTAL DUE S -t' • ~