HomeMy WebLinkAboutNo 12094 i
I
City of Lakeville
INSPECTION DEPARTMENT
Valuation 50 , ~C~~ . '
s~?~s BUILDING PERMIT .u
~at.e~ LTtlit Building Permit Fee ~fl
& Receipt
545 `:~w~r. ~Yri3:t- T'~j, State Surcharge 2~•€b;,3
:x'25 Se;~~r ~rAa P~> 3f~,~~;
TOTAL FEE PAID
Permission is hereby granted to 3v ~p~ ~ P~ f ~ l'~r ;:o>Lzs t
Building on Lot No.: ~ ~ -Block 1 1 Subdivision ~1S~S~I+~~~~~~~'~1:~~ ~z13 ~~dA
Parcel ~f 7'1< 1~7 _~'~._l Plat
in theClTY OF LAKEVILLE to be used as tj,~mrit- ~~tRf~~~~f~ ~~~g~~ ~Atst3~sa'--~~~'c~aYr
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 alt work shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota.and the State of Minnesota
pet#aining to the construction of buildings.,
street Address -7.~~2~1!' p,=,~t~s~~ ,lv~xtu~ Si~4` ~~i1;3.er
Director, License and Inspection
Attention is particularly called to the cutting up of streets, making main sewer j K
connections,drivewaysandcurbs.ObtaiopermitforsuchconstructonfromtheClTY '~J
~ OF LAKEVILLE. Inspection: Department 1JoL Responsible For Any Damages to By ,~,f ~ / ~ ~
Public Utilities.
/ J
Q
A\\~~'~
v
v
~ i ~
~ ~ ~
~ ~ ~
APPLICATION FOR. BUILDING PERMIT
CITY. OF LAKEVILLE
8747 208th St. W. P.O. Box M
halceville, MN 55044
469.-4431
Job Site .Address:
Legal Description: Lot_ ~~1'
':Block l% '-Addition ~ ~
Owner Phone
Address
~ Phone
Contractor
Address..
Class of Work: )Erect ( )Alter ( )Repair (.)Enlarge ( )Move ( ) Demolish
r b in Detail -C1 ~ ~ ~
tre~sei Use (~esc i e )
Heating Contractor ~L
~ ~
Plumbing Contractor ~~,L~
Sewer & Water Contractor's
Electrical Contractor~i%
d~"~G~~'~~''
I
Special Conditions
Valuation of work.: S Q: ~ ~3~, ~d~
Si ure of Applicant & Title: ~ FOR CITY USE ONLY
l Zone
~ % City. Fee S ~ ~`L-
Date Plan Check S
Signature of Zoning Officer : Surcharge S ~
SAC $ ~s...~~.~ ~
Hook-ups S~c~ ~
Date
Area Charge $ , e
Signature of Building Insaector;
Other S
Total S~~, ~ P,.~'~
3
Date