HomeMy WebLinkAboutNo 12106 _
City of Lakevirle
' INSPECTION DEPARTMENT
,,r, ~ ~ y Bl1I La I NAG PERMIT Valuation
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5~4,'~ . St~~c'.T t: r`r3:, & I~EiL.@Ipt t3uildingPermitFee 2$~_f~p
';:=_°.rex ra.~';~~ i<~. State Surcharge '~~-nQ
TOTAL FEE PAID
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Permission isher~ygrantedto ~~~€~~?i '~~~~~~r~~'t~{~~~
i BuHding on Lot No. ~a' Block __~Q _ Subdivision Tinnnn~g Va11 ~~sr }`~~rte At•ii ArlAp
Parcel ~ ~.>~i.~.~7.>~(}:~1 1 Plat.
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~ to the CITY OF ~.AKEVILLE to bevsed as "
This permit is issued on the express condition that the _~~RECTION- -ALTERATION -~-REPAIRS
-ENLARGEMENT -~IIOVING DEMOLITION respects to the tatements certified to in the application for
such permit, ancpahat all work shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and the State of Minnesota
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~ pertaining to the construction of buildings.
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Street Address iP,.~i:,:i
Director, License and Inspection
Attention is particularly called to the cutting.up of streets, making main sewer.
connections, driveways and curbs. Obtain permit for such construction from the CITY ~~~~"T"*--
pF LAKEUILLE'lnspection Department Not Responsible For. Any Damages to By '
Public Utilities.
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APPLICJITION FOR BUILDING PERMIT
CITY OF LAKEVILLE
8747 208th St. W. P.O. Box M
Lakeville, MN 55044
469-4431
Sob Site Address: _ ~~.~~3~ 1-~~'~~~-~ ~j''
Legal Description : Lot O • Block f
c~ `Additions, ~ .~"~',G L'
Owner Phone
Address
Contractor Phone ~~'7`
Address ~
Class of Work: (~rect ( )Alter O Repair ( )Enlarge (.)Move ( ) Demolish
Proposed Use (Describe in Detail) G~~l~``. ~ ~ ~ ~~Q~
Heating Contractor ~~L>GC-~
Plumbing Contractor
Sewer & Water Contractor
Electrical Contractor C
Special Conditions
' Valuation of Work: 5 ~
Signature of Applicant & Title: ~ FOR CITY ySE ONLY
~ Lam` Zone
~i~~~~~ City Fee S G'G'
Date o~ /S' a 7`~ glen Check S
vn 0
Signature of Zoning Officer:. Surcharge S
SAC S ~.~2C ~ c~
Hook-ups S 1 c U~
, Date
Signature of Building Inspector: Area Charge S_ ~ ~ ~i ~ ~
Other S
Total S ,t
Date