HomeMy WebLinkAboutNo 11972
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~ City of Lakeville
fir.z5.:~i1: s~,c INSPECTION DEPARTMENT
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~~7'~:~;i:, ~~=~~:r ;~r~a BUILDING PERMIT ValtJation
45%~ , ~ t+,4 € i."xa~ t ~u . Building Permit Fee ~ ~C!
} r & Receipt
State Surcharge .
TOTAL FEE PAID 3t}$ e tl~J
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Permission is hereby granted to
Building on Lot No. ~ Block Subdivision 17ASiYtayei Fork Attu
Parcel tt .'_~;i: t 7--`?~~€} °i;• Plat
I €r>theCiTY OFiAKEVILLEtobeusedas {'~"`~~t Ct,~"~t:t»t•it'"~' fartiZ~° M®~~1" #~9~~54
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E This permit is issued oin3he express condition that the ERECTION -ALTERATION --REPAIRS
` ENLARGEMENT MOVING DEMOLITION :respects to the statements certified to inihe application for
such permit, and that all work shall be done in accordance with sthe Ord€nance of iAKEVILLE, Minnesota and the: State of M€nnesota
pertaining to the construction of buildings.
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Street Address ?fi'~'~+"° -=:~~«~rir* t~7a.
.Director, License and Inspection
Attention is particularly called to the cutting up of streets, making main sewer
connections, drivewaysahdcurbs.Obtainpermitfor'suchconstructionfromtheCiTY'; ~ '
OF LAKEVILLE: Inspection Department Not'-Respohsble For Any Damages to By ~ ~;~'~'-~"=p`~! -
Public Utilities. 'r
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APPLICATION FOR BUILDING PERMIT
CITX OF LAKEV ,LLE
8747 206th St. w. P.O. Box M
Lakeville, MN 55044
469-4431
Job Site Address:
Le al Descri tion: Lot •Block ~ Addition r'
4 P
Owner Phone
Address
Contractor Phone
. Address
Class of Work: (Erect ( )Alter ( )Repair ( )Enlarge ( )Move ( ) Demolish
Proposed Use (Describe in Detail)~!y
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Heating Contractor
Plumbing Contractor
Sewer & Water Contractor
Electrical Contractor
Special Conditions
Valuation of Wark: 5
Sig of Applicant & Title: ~ FOR: CITY USE ONLY
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zone
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J City Fee S ~ ~
Date l~ `',y ` ~+lan Gheck S
Signature of Zoning Officer: _ Surcharge S ~
SAC S ~
Hook-ups 5~~~
~
Date
Signature of Building Inspector;. Area Charge S_~, ~
Other S
Total S ! { Ems'
Date
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