HomeMy WebLinkAboutNo 13542 T
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VaiUatjon 57. w9Q_t!!1 Water Unit ........,..~8.2'Q.90 ~
Clt~/ Of Lak2Vl I12 ' , 'Bldg. Permit Fee 3Q~ • dd Sewer Unit 6d5 • dd
State Surcharge 29 . dd t Area ...$lEW~2T. 250. dd
Metro SAC Charge 475 • d~J Park Fee .
Other ..$~,8tt . ~~'1t~GTIG . 2dd. dd .TOTAL PAID... ..$~,..~iig6.00
BU1 t~ING PERMIT
Receipt
Permission is hereby granted to .TO>ER • ~.~.1@Y' t;~AE3tX'uCt~.Otl
17 Block Id subdivision Itonna~°s p~~-I~y PaYk 8th Addn
Building on Lot No.
Parcel No. ~~-'L217Z~°17~-1C~
I" in the CITY OF ~.AKEVItLE to be used as ~ armi t to nnnnt~3iC.t--$~~.Ii~ ~a$1p'~~T~1+~6~~~
4 This permit isPs$uedontheexpressconditionthatthe ~ ERECTION. ALTERATION REPAIRS
ENLARGEMENT MOVING DEMOLITION respects to the statements certified to in the
applicatign for such permit, and that all work-shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and
the State of Minnesota pertaining to the construction of buildings.
Street Address j~R~7 Fnr?tneiat Av~n~a iLniri F liL~,t»~~
Director, License and Inspection
Callforinspections- 469-4431. BY
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BUILDING PERMIT APPLICATION
ONE AND TWO FAMILY RESIDENTIAL j
CITY OF LAKEVILLE J
INSPECTION DEPARTMENT f ~
8747 208TH STREET W.
P.O. BOX 957
LAKEVILLE, MN 55044
469-4431
DATE: ~f ~ -
JOB SITE ADDRESS : ~l ~~'7 .~,,~e~J i.--~~
LEGAL DESCRIPTION: LOT: / BLOCK: / ~ SUBDIVISION OR SECT ION ~L~~m'n'~cc~.z_,
OWNER : PHONE : ;~`c~ cu ~
STREET ADDRESS: ~`~A"^ CITY: ZIP:
CONTRACTOR: ?~l ~C-C~¢.c1 C~ PHONE: Z !~c' ~
STREET ADDR : ~ ~ ~'tely ~~-~-/-~-i' CITY : ~R-? ~ ZIP : Z-
CLASS OF WORK: NEW:~ ADDITION: ALTER/REMODEL: DEMOLISH:
PROPOSED USE (DESCRIBE IN DETAIL):
VALUATION OF WORK (EXCLUDING LAND) : 3Z ~ ~,~~~j
I HEREBY APPLY FOR A BUILDING PERMIT AND I ACKNOWLEDGE THAT THE INFOR.'~IATION
ABOVE IS COMPLETE AND ACCURATE; THAT THE WORK WILL BE IN CONFORMANCE WITH
THE ORDINANCES AND CODES OF THE CITY AND WITH THE STATE BUILDING CODE; THAT
I UNDERSTAND THIS IS NOT A PERMIT AND WORK IS NOT TO START WITHOUT A PERMIT;
AND THAT THE WORK WILL BE IN ACCORDANCE WITH THE APPROVED PLAN.
FOR CITY USE ONLY
Appl'cant's Signature:/
~yy-- ~ Date: Zone
Permit Fee $ ~'X .
Plan Check $ ~ G`G •
Building Official 's Signature:
Surcharge $ •
Date: °''~-w~
< SAC $ ~j . C~>~~ ~~~~~~~i
Comment s_: _
S/W Units $
Sewer Area $ .
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Park or Misc. $
TOTAL DUE $ ~ ~