HomeMy WebLinkAboutNo 14478 ~gai-ch 30, ~g 87 I
Valuation Water Unit
...City Of L~keVllie Bldg. Permit Fee SevoerUnit
State Surcharge Street Area i
Metro SAC Charge Park Fee .
-BUILDING PERMIT other. I~.oo roTat_ Pnio....... X15.00
Permission is hereby granted to Hessel~raVe ~ t'~,mer
Buiiding on Lot No. Block ~ 12 Subdivision ~ 4'all:eq Park 8th
a ~ ! .
,I~,~roet No. 22-21177-IO~i=12
i
in tt~CITY OF LAKEVILLE to be used as P`~rrzzi t tU~r~ct 6' privacy f once it near yea>~d
This permit is issued on the expressconditionthatthe ERECTION ALTERATION REPAIRS
h' ENLARGEMENT MOVING DEMOLITION respects to the statements :certified #o in .:the
applrcat
on 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. _
street Address 361~(.i F`~ir~;r~en Ay~z~u~ ll~vid nri.~:
Director, License and Inspection
t:~
Call for inspections-469-4431: By '~~-~~°A i ~
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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: - ,Z~` c~`~
JOB SITE ADDRESS: ~lp~~'~ ~-~-),~(-~,'~~L,~1 ~L~~
LEGAL DESCRIPTION: LOT: BLOCK: SUBDIVISION OR SECTION: ,~.~y,tirC
OWNER: /~Ei,c. ~~st,~.WQ~~~ PHONE: ~f~~I -`f ~`~~j
STREET ADDRESS: _ /l~j~~ ~jq-j,~'(~,~~E~ ~~IE.. CITY: ,~D,Sc77'7C~t.~,t,' ~ ZIP: ~~~f~Crr~~
CONTRACTOR: PHONE:
STREET ADDRESS: CITY: ZIP:
CLASS OF WORK: NEW: ADDITION: ALTER/REMODEL: DEMOLISH:
PROPOSED USE (DESCRIBE IN DETAIL) : ~it:S'TK}t1.~ix:~ l~ ~ f 1 y~}C Y ~~7(~' ~
i2L f,? ~ ~ `~C ~ ~"J~ )YYI ~ ~J"~-~2 ~ F' L c> `f- ` T~ i~-~ c> ~ ~ c ~~,~6,
~ ` '-7i ~ L° ~ E ~-~t2 ~~F'T~ i> C° 6 ~r ilk C' 19 P
VALUATION OF WORK (EXCLUDING LAND):
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 T~IIS 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
Appl'ca s ign ure
Date -2.$r~,~'` Zone
Permit Fee $ J,~
Plan Check $
ilding Offi 'al 's Signature:
Surcharge $
Date: ?v
SAC $
Comments:
S/W Units $
Sewer Area $
Park or Misc. $
TOTAL DUE $ O"~