HomeMy WebLinkAboutNo 11769 • Ttttta fi ~ , 19-~3~3
~ ~ City of Lakeville
INSPECTION DEPARTMENT
14~.r.~n ~~,ar~~- tlt~i~ P~ BUILDING PERMIT Valuation 52,OQ~}.~~
54S ~3°:~ S~eW~'T 'Cltt:;lt ~.'C's Building Permit Fee 28b • flt!
z~ 3.>>~ ~e~r~:r Px~:a. & Receipt 6.Od~
State Surcharge
TOTAL FEE PAID 312. in`
Permission is hereby granted to .~4ffiiu T:a~'i M . M3,~ ~~T Ct9Tt~t , y ~F;.'tC .
~ Btlllding On LOt NO. ' ~ BIOCIC - A:.~~i $UbdlVlslOn ~.a-rttaac-„~~-e y ~s°rc a v ci= maZ7l.
Parcel ~f~~ 1;x7~Cfit`~-10 Plat
is the CITY OF iAKEVILLE to be used as ~ _
This permit is issued on the express condition that the ~-ERECTION ALTERATION -REPAIRS
ENLARGEMENT MOVING ;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 LAKEVFLLE, Minnesota and the State of Minnesota
pertaining to the construction of buildings.
12.54 F~rrtancir~ ;wyt8 1~111~.r
Street Address ~
Director,. License and Inspection
Attention is particularly called to the cutting up of streets, making main sewer _
connections driveways and curbs. ObtainpermitforsuchconstructonfromtheClTY '
OF LAKEVILLE. Inspection Department Not: Responsible For Any Damages to ; By > .~I w~~~ ~r ~f .
Public'Utilities. 1
1
F
' APPLICATION FOR BUIL I G ~ERMIT
` CITY OF LAKE LLE
874"y` 208th St. W. P.O. Sox M
Lakeville, MN 55044
4f,9-4431
Job. Site Address: ~ ,
Legal Desczintion: Lot ~ Block /p Addition ~
Uwner Phone
Address y~
e~L:.C~G~/~/ hone.
Contractor Y`.~Y~~s~
Address / ~ ~ ~
Class of Work : Erect ( )Alter ( )Repair ( )Enlarge ( )Move ( ) Demolish
Proposed Use (Describe in Detail) 1.: ~
Heating Contractor G~~/~~
Plumtiifig Contractor
~r
Sewer & Water Contractor
s ~ o
Electrical. Contractor
Special Conditions
rr,-~
Valuation of Work: S ~ f~~,
~~Q
Signature of Applicant & Title: FOR CITY USE ONLY
Zone
.,~L~~ City Fee S C3' t3 Q o
~
bate Plan Check S O
Signature o€ Zoning Officer: Surcharge S ~ <O , ~
SAC $ /d' ~U~`
Hook-ups 5~,~ U ~ r O d'
Date
Area Charge S 7 S ~ ~
Signature of Building Inspector:
Other S
Total S ~ ~ ~ / .
Date 1