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No 12650
_ _ March 11, is `3 Valuatioh 1 a S ~t~ . Water Unit . ~ltyOfLakeVl~~@ Bldg. Permit Fee..... Sewer Unit. ..State Surcharge ~ ' Street Area . . . T Metro SAC Charge Park Fee . . B U ~ L ~ ~ N G P~ R M I 1 Other TOTAL PAID, ~ 2~. OC Rece i p# Larry 3ba~t@xa, Owner ~,~o? _:~~a Permission is hereby granted t© ~ a V~1 ~ act Park: Rt1~ A.~~~, Building on Lot No.~;T Bloch 1 n Subdivisioh ~t1z1Ac'~~ Parcel No. ~'?2_211~7-H2O-lfl in theClTY OFiAKEVILLEtdbeusedas' Permit. to fi;tish t~~aem~ttt 1€~w~r 1.+~ve3 This permit is issuedonit~expressconditionthatthe ERECTION ALTERATION REPAIRS ENLARGEMfdVT MOVING DEMOLITION respects to the statements. certified to in the application for such peFir~it, and that all work shall be done in accordahce with the Ordinance of LAKEVILLE, Minnesota and the Stare of Minnesota pertaining#o the construction of buildings. Street Address Ifa 1 7 T'ant€~sia A~r~+nti~+ - ~.irl a4i i i ~sr ~ _ rector, License and Inspection Call for inspections - 469-4431. By ~R ~ ~ E ~ . ~ ~ ~ ~ ~ ~ z ~ , APPLICATION FOR BUILDING P~iIT CITY OF LAKEPILLE 8747 208th St. W,, P.0.3ox-957 . Lakeville,. MN S5044 (612) 469-4431 Job Site Address. ~ f~s'~~-- ~ Legal Description: Lot Block Addition _ _ _ Owner ~_At~Y'V ~~L~ S Phone _ `y l ~ Address % ~1, ~t`~ e? l :y s r~-- ~ P .O.Box;.~ ~ , ~ Citl I'SG~E ~ Du~~. Zip S-~"~~, Contractor ~ .,J v[!5 r~ ~ Phone ~ 2 ~ ~ Address 1l7 C-~,,;/~~,w~ ~ P.O.Box:~ ~U City o5c=~<~tic1~-r<,'~.... Zip 5-SDly Class of Work: ( ) Erect ( ) Alter ( ) Repair ( ) Enlarge ( ) '_•iove . _ ( ) Demolish Proposed Use (Describe in Detail) ~ 5 ~ lL..?~~;t'r~('~~77 l~'~c~~'~'~ N v Covmmercial: Square Feet. ~ Employees Heating Contractor y~ n r Plumbing Contractor ~7 w' ~ Sewer & Water Contractor t"~ t,~1 f1 ~ Electrical Contractor ~;.~ti'~ r~~r"` Special Conditions Valuation of Work: $ ] ~ C% ~ vc> FOR CZT° USE ONLY .Signature of Applicant ~ Title: rz3~ /J f City Fee $ ~ S G D ~rt~. Plaa Check $ Ci'u.~, Date / Cj - ~ j Surcharge - $ _ J , ~ ~ SAC ~ $ Signature of Zoning. Officer: S/W Units $ • Date Seiner. Area $ Signature of Building Official: Street Area $ Park or Misc. $ Data: Total $ Ls~- ~ c?.-: SID MILLER, BUILD~TG INSPECTOR