HomeMy WebLinkAboutNo 12490 f {
cyn September 14, 19 84 is
1
Valuation ...~54,Q(TO.Of~ Water Unit. ...........__7Q~?
n~-.-~^-
Clay Of Lakevi Ile Bldg. Permit Fee • 00 Sewer Unit ~7~-. n-o0- I
~ $ • 4a Street Area .
State Surcharge
Metro SAC Charge 425 • Park Fee I
BUILDING PERMIT other sWX./~r~.'2....... 2-3~-.~-9- .TOTAL PAID.........~2,32fi_f1(1 _
Receipt
Permission is hereby granted to M Miller Constrnrt•ir,n
Building on Lot No. 1Fs Block ~ 1 Subdivision dxt.
422-21177-16Q-1Z
Parcel_NO.
in the CITY OF LAKEVILLE to be used as Kermit to eon~tritct- 4~i..x7~.~1~-~~a-. ~ ~ =-1
This permit is issued ontheexpressconditionthatthe _.Y-ERECTION ALTERATION REPAIRS
ENLARGEMENT MOVING DEMOLITION respects to the statements certified to in the
application 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.
1h30$ Fantas~Ls. ~~.renue Sid l~iiller
Street Address
Di~ePCtor, Lice/nse and Inspection
Gall for inspections - 469-4431. BY .
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APPLICATION FOR BUILDING PERMIT
/O,j ~ CITY of LAxEVILLE
8747 Z08th St. W. P.O. Box M
r Lakeville, MN 55044
469-4431
Job Site Address: ~ ~ .,~~,~'i
Legal Descriptions Lot ••B1~k~Addition~ 1 ~
pier ~ ~ Phone
Address
Contractor Phone
• Address '
Class of Works ~ Erect ( )Alter ( )Repair ( )Enlarge ( )Move ( ) Demolish
Proposed Use (Desscribe in Detail)^ L/./J LC%
Heating Contractor f
Plumbing Contractor i~%~ ~~L!/~i
Sewer ~ Water Contractor
Electrical Contractor
Special Conditions
Valuation of Works S ' i
Signature of Applicant t Title: ~ FOR CITY USE ONLY
• ~ Zone
~ City Fee S ~C ~C. ~ - G'c5
to - Plan Check S
Signature of Zoning Officer: Surcharge S
SAC S ~t -
-r
Hook-ups S~,!-,,~+~
Date
Signature of Building Inspector: Area Charge S c'~ ~ y
Other S
f
Total S,~ ~e ,t~ ~,.f
Date