HomeMy WebLinkAboutNo 12227 i
. r,J ' tLgri.~ 2~, 19-~~
City of .Lakeville
INSPECTfON DEPARTMENT
~~z~ ~~r ~a BUILDING PERMIT Valuation ............~~,~~a.~
Wa~~r Ilnir s~,~. I
r ~ Building Permit Fee 2F~;i ` ~
~~t~~ c,.~~. . & Receipt 2s.o
2 a ~ eU7~ r ra State Surcharge .
TOTAL FEE PAID 3Q$ •
Permission is hereby granted to ~a~f`«w'. F"' >,t ° ti. i ~ ~c,r ~
~ ~.Xt?t: w 3 e3tl
'Building on I~ot No. ~ Block ~ `Tf Subdivision ?~t~rtbT,~V' ~ S ~ nth A,ddtt
Parcel si~'~.'~'°G~~.~1~.,Z~jr?~,r~Plat
in the CITY OF LAKEVILLE to be used as ~ • " - '
This permit is issued on'the express condition that the Wit--ERECTION ALTERATION REPAIRS.
_~NLARGEMENT MOVING ~-DEMOLITION respects to the statements certified to in he application for
such permit, and that all work shall be done in accordance with the Ordinance of LAKEVi~LE, Mir?nesota and the State of Minnesota
pertaining to the construction of buildings.
Street Address jn?.:°' ~~.rn~n~~'~t~v `=3.?i ?~fi1~,4~z'
.Director, License and Inspection
..Attention is particularly called to the cutting up of streets, making main sewer
connections,drivewaysandcurbs.ObtainpermitforsuchconstructionfromtbeClTY,
r'
OF LAKEVILLE.,Inspectiort Department Not.=Responsible For Any Damages to Sy ~ b~ -
Public Utilities.
~ 4
n APPLICATION FOR BUILDING PERMIT ~
-.i ~ CITX OF` LAKEVILLE ~ f ~ ~ ~ r~
8747 208th St W. P .O. Box M ~ 2
Lakeville, MN 55044. rr
469-4431
Job Site Address:
Legal Descript _ Lot ~
..Block /Q Addition
~
Owner Phone
Address
Contractor - Phone °jj~~~- ~~5
;
Address ~c~/
Class of Work: ;(Erect ( ).Alter ( )Repair ( )Enlarge ( )Move ( ) Demolish
Proposed Use. (Describe in Detail)
Heating Contractor [~~~~Z:(~ ~
Plumbing Contractor G~- ~
Sewcr & Water Contractor
Electrical Contractor ~
Special Conditions
j n e ~
Valuation of Work: S _~-'~'i~;~-
Signature of Applicant & Title: ~ FOR CITY USE ONLY
.~~~7~ Zone
City Fee $ ~~J
Date ~ ~7 Plan Check S
Signature: of Zoning Officer; Surcharge S ~ "
SAC S ~ 47 ~ ~
Hook-ups S
Date
Area Charge S c°
S -
Signature of Building Insaeetor:
Other S
Total S ~
Date