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HomeMy WebLinkAboutNo 12155 ` City of Lakeville ~~25~nr~ ~A~ f NSPECT-ION DEPARTMENT ~s~.!~c w~*~~ '''~•BllILDING PERMIT valuation 5a,9ia~©~ , 57S ,Cry ~ewirar t;n~.t F:i > Building Permit Fee 2 F, ~ {f(3 f s~~r & Receipt 25.00 ; Slate Surcharge % TOTAL FEE PAID Permlissionisherebygrantedto Joi~i~~ls '~i11~t Co~t~t°' In~t~" Building on Lot No. Block ~ ~ Subdivisittrt 1)oz#r~g~~ i~all~v perk f3t3~ A-~rizt Parcel X22-21177-1.1.08-12 Plat in the CITY OF IAKEVILLE to be used as= ; ; ` A I This permit is issued on the express condition that the ~_..EREGTION --_-ALTERATION y -.REPAIRS F _-ENLARGEMENT -_iiiIOVING ---DEMOLIT80N respects; to the statements certified to in the appiicationfor such permit, and that all work shalt be done 8n accordance with the Ordinance of LAKEVILLE, Minnesota and the State of Minnesota pertaining to the construction of buildings. street Address ~'~.r,.~ta~i~ Ay~n.ie Si,3 Milieu Director, License and Inspection Attention, is particularly called to the cutting up of streets, making main sewer f " connections drrvewaysandcurbs.ObtainpermitforsuchconstructionfromtheClTY ~ ,`J . OF tAKEVILLEa Inspection Department Note Responsible For Any Damages to By r ~ 4 Public Utilities. `M s . o N ~ ~ - APPLICATION FOR BUILDING PERMIT • CITY OF LAKEVILLE 8747 208th St. W. P.O. Sox M Lakeville, MN 55044 469 -4431 - ~ , .Job Site Address : /~p,~/~`~.-~'~C~~Z-~~-~-•~'' Legal Description: Lot • ~Slock Addition Owner Phone Address ~,7 Contractor s~,~~ G-~~' _ Phone ~g`~ • Address % Class of Works (Erect ( )Alter ( )Repair ( )Enlarge ( )Move ( ) Demolish Proposed Use (Describe in Detail) ` t, HeatYng Contractor (~//~~•C~:~ GC~~/ Plumbing Contractor ~ Sewer & Water Contractor Electrical Contractor R Li''~~-~-~-~ Special Conditions Valuation of Work: S ~ ~ + Signature of Applicant & Title: ~ FOR CITY USE ONLY ~1 a Zone ~ - 1~ City Fee S C~~ Qom' Oats Plan check S Signature of Zoning Officer: Surcharge S ~ ~ ~ SAC S C? r D ~ Hook-ups S~ ate Area Charge $_,.~_S~ ` " Signature of Building Inspector: Other S Total S ~ ~ ~ Date