HomeMy WebLinkAboutNo 11852 .Su1y ~6$
$3
City of Lakeville
INSPECTION bEPARTMENT
i4~.i..p ~~i~.~ ~~,BUILDI1dG PERMIT valuation 5S}.;()~f~~~5~} 1
S4~`:.p~J Sewer t~ni~ ~c~. ~.87.Qp
~ ~ RE;C@I p Building Permit Fee . .
State Surcharge 25 •
' TOTAL. FEE PAID
~ Jrse~gh Pte. ~.lex• ~o~t~t,~taetion
F ~ Permission is hereby granted to
Buildir?g On LOt No. ~ i3lock ,21 Subtiitrision ~n„~~v® Vsl7ov 7'lnrSs st+-~ ~a~t~
t Parcel ,~`~2~-21.~17~~.?3^-2l. Plat
in theCiTY OF LAKEVILLEtobeusedas ~''"r~r'f:~~ t4" k~ti~L~"'tY~.t ~1a,3s~~.~ fEti~.ly dki'~ll~tl.~ I'~c9d4@1 95C}~4
This permit is issueif on the express condition that the' ERECTION '-ALTERATION -~iEPAtRS
ENLARGEMENT -JVIOYING -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 LAKEYILLE, Minnesota and the State of Minnesota
.pertaining to the construction of buildings.
Street Address ''~i~2~' ~`~rr~r~~~ t;~w.._ ,id Mi1~.ez
Director, License and Inspection
~
Attention is particularly called to the cutting up of streets, making main sewer ra
connections, driveways and curbs. ObtainpermitforsuchponstructionfromtheClTY '
OF LAKEVILLE. Inspection Department Not Responsible For Any Damages to By a~ ~
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Public Utilities.
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~~/APPLICATION FOR BUILDING PERMIT
CITY OF LAKEVILLE
8747 208th St. W. P.O. Box M
Lakeville, MN 55044
469~44~1
Job Site Address : X02 7~
Le al Description• Lot
4 _ ~ Block Addition,
..Owner Phone. Y ~.~~3
Address
Contractor d~%~ Phone ~'7-7°~.~`-3
Address L i~
Class of Work: (,Erect O Alter ( )Repair ( )Enlarge ( )Move ( ) Demolish
Proposed Use (Describe in Detail) i~~g~(~r~ ~ ~
Heating Contractor
Plumbing Contractor
Sewer & Water Contractor
Electrical Contractor
Special Conditions
Valuation of Work : $ p,
Signature of Applicant & Title: FOR CITY USE ONLY
Zone
__~°~/~/L~~ City Fee S ~ ems'
Date ~~f® O~ Play Check a
Sin of Z
g ature oning Officer: Surcharge $
SAC ~ P.~
Date Hook-ups ~ GG!
Area Charge $ ~
Signature of Building Inspector:
Other $
Total $ ~ .?i
Date