HomeMy WebLinkAboutNo 11771 m ' . pity of Lakeville
. , ~:1. ~ r, R I N~PECTI ON ~ DEPAR7M ENT;
s~~_BUIL'DING PERMIT Valuation +~?*CY~i!.~~
~ s _ .t !.b.z `t" ~a°.i4 A'~.~ Building Permit Fee . , r 92 .
& Receipt:
+ ~ . ;_+a' s `•.`z`i. State Surcharge i
TOTAL FEE PAID
Permission is hereby granted to ~ ~ ~ ~ ~ ~ ~ ~ ! i TP d'
Building on Lot No. ~ Block w Subdivision ._:•..,a er<.~ ; a., s~fitw n.t,~n~
Parcel ''`i. w> ~ ~zL, Plat
in the CITY OF"LAKEVILLEtO be used es' '~'Y`Y.''7-t ~c3 `-'~`s-~€ tT„~~-'-,`7 ~ ' ~ '~s-~~~`) ~f°~
~ permit is issued on the express condition that the '-.~~RECTION ALTERATION -JiEPAIRS
_~NLARGEMENT MOVING DEMOLITION respects to the statements certified to in the application far
.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 batidings.
Street Address ~ ~a ~ , t ,
Director, License and Inspection
Attention is particularly called to the cutting up of streets, making main sewer f
connections, driveways and cu rbs: Obtain perm it for such constructioh fromthe C ITY
OF LAKEVILLE. Ins ection De artment Not Res onsible For. An Dama es to B r ~ s-~F 'a.-~'"kf
P P P Y 9 Y -:a t > 4
-Public Utilities. ~
v ~
~ 4
APPLICATION FOR BUILDING PEFtH9TT
CITY OF LAICEVILLE
8747 06th ~St. W. F.O. Box M
Lakeville, MN; 55044
469-4431..
Job .Site Address ; ,.~o~~?L.Qi~
Lea Description: Lot r .J
g _ ~ Block Addition
4 ~
Owner ~ /C.,/~~~~C.~~~~ C~ Phone ~.~7 - ~~Jf~
.Address
L~~-
Contractor. Phone
Address
Class of ,Work : ~ Erect ( )Alter ( )Repair ( )Enlarge ( )Move ( ) Demolish
Proposed Use (Describe in Detail) i~~~
Heating Contractor
Plumbing Contractor
Sewer & Water Contractor
G
Electrical. Contractor ~
Special Conditions
i
Valuation of Work: S ~;;~j"'` C..i ~
~'T
Signature of Applicant & Title: FOR CITY USE ONLY
Zone
City Fee ~ +®O
Date~_- ~ plan Check $ ~ Q
'Signature of Zoning Officer; Surcharge $ ~ ~ . ~ ~
SAC $ ~ ~ ~
Hook-ups $ d~`~
Date
Area Charge S ~
Signature of Building Inspector:
.Other $
Total $ ~ ~ ~ "%~..4~
Date