HomeMy WebLinkAboutNo 12156 - - ~
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City of LakeviCle
~~44' INSPECTIQN DEPARTMENT
7~0.~~ * r.~BUILDING PERMIT Valuation -"?~t3bt~.C+J
>7 " ,f,}~"7 Sew~~' '~ntt ~3. Building Permit Fee • ~
sewer' ti~~~ & Receipt
- State Surcharge • Q~
TOTAL: FEE PAID •
Permission is hereby granted to ToPC?~~i J~+il~;o~~ ~c~~~~t:.' rrtc•
Building on Lot No. 9 ? Block ~ Subdivision Pe.xk s?th Ad~ln.
i Parcel ~r'22-217 "-2:~C~-' Plat
in theClTY OF LAKEV1LLEtobeusedas YGI''^~~ rt1*'e~t:t3~YCt '~~~~'~`r--~~aellin~
This permit is issued on the express condition that the Y ERECTION -ALTERATION -J~iEPA1HS
_-ENLARGEMENT -MOVING _ ~~EMOLITION respects to the statements certified to in he application for
such permit, and #hat aN work shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and the State of Minnesota
pertaining #o the construction of buildings.
Street Address Faxaf:esia :~yer~ue c~~t Mf ~.~:er
Director, License and Inspection
Attention is particularly called to the cutting up of streets, making main sewer Jj, '
connections, driveways and curbs. Obtain permitforsuchconstructionfromtheClTY y'J~,
OF LAKEVILLE. Inspection .Department Note Responsible For Any Damages to By rl ~
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:'Public Utilities.
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3 J~ APPLICATION FOR ~UILDINfG PERMIT
CITY OF LAKEVILLE
8747 208th St. W. P.O. Box M
Lakeville MN 55044
469 -4431
Job Site Address : , ~
Legal Description• Lot~Block Addition ~
Owner Phone
Address
Contractor /~G+~ L~G~~. Phone /~~5~~
Address n ~ L:,G-C~~,
Class`of Work: ( Erect ( )Alter ( )Repair ( )Enlarge ( )Move ( ) Demolish
Pro,~osed Use (Describe in Detail) 'J~s~--°°~ ~ r:.--
Heating Contractor ~,~'G-~~~~ G~'~'~
Plumbing Contractor ,r~~~~ , ,C~!~,, f
Sewer &.Water Contractor
Electrical Contractor
Special Conditions
Valuation of Wark: $ ~ C~:
Signature of Applicant & .Title: FOR CITY USE ONLY
~ Zone
c City Fee $ ~ ~
Date
d Plan Check $
Signature of Zoning Officer: Surcharge $ ,.~(,f
SAC $ r7" o~ Q
Date Hook-ups ~ ~ ~
Area Charge $ a2 ~ ~ ~
Signature of Building Inspector:
Other $
Total $ t~~' ~
Date