HomeMy WebLinkAboutNo 11853 City of Lakelville
INSPECTION DE ARTMENT
$~~~~,c~,~ wat:~~~u~tit r~ BUILDING PERMIT Valuation
545. ~f~ S~~a~x~ t~Ftit~ ~d, 81. RG'CG'i t Building Permit Fee a~.+?
ZZ~.O~ 'S~w~r fir~~, ~d. State Surcharge 25.Ub i
TOTAL :FEE PAID. 212 • QQ
Permission is hereby granted to s j
Building on Lot No. ~ lock l~l Subdivision r~~ ~ yta~~+~--w ~
Qott
parcel'4?'~^2~..ry.77-02~-2(~ Ptat
in the CITY OF iAKEVILLE to be used as ~ g
.This permit is issued on the express condition that the ERECTION ---ALTERATION -_._-REPAIRS
.-ENLARGEMENT MOVING EMOLITION respects to the statements certified to in the application far
-such permit, and that all work shall be done in accords ce with the Ordinance of'LAKEVILLE, Minnesota and the State of Minnesota
pertaining to the construction of buildings..
JLfi1Gu ~;:,rs.a~-t,~a ~1€zy S~.d M9..~1cr
Street Address
Director, License and Inspection
Attention is particularly called to the cutting up of streets, aking main sewer" ?
connections, drivewaysand curbs. Obtain permitforsuch constru tion from the CITY ~ •
OF LAKEVILLE. Ins ection De artment Not Res onsible Fo An Dama es to B f .~"a'~/
P P P Y 9 Y •4".-~--~~.~
Public Utilities.
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LICATiON FOR BUILDING PERMIT
_ ~ CIT QF LAKEVILLE
8747 208 St. W. P.O. Box M
Lakev~,ille, MN 55044.
' 469-4431
Job Site Address:: ~~p~®~r
Legal. Description: Lot ~ Block ~~1 Addition fJ G'L'~~~ G^
II
Owner ~ Phone
Address
Contractor j~ Phone ~Sy ~ ~~~3
Address ~ ~3.~
Class of Work: Erect ( )Alter ( )Repair ( )Enlarge ( )Move ( ) Demolish
Proposed. Use (Describe in Detail)
Heating Contractor
G
Plumbing Contractor
Sewer & Water Contractor
Electrical Contractor
Special Conditions
Valuation of Work: $ ~ ~d~
Signature of Applicant & Title: FOR CITY USE ONLY
j
Zone
City Fee $ T O
Date ~ °~..3 Plan Check
Signature of Zoning Officer.: Surcharge $
SAC $ „
Date I Hook-ups $ G~~
Area Charge $ ~ -
Signature of Building Inspector: ~
Other
Total $ f f/
Date