HomeMy WebLinkAboutNo 13565 / - -
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Valuation 71jCt . c~ J Water Unit
Clt~/ Of LaI(2VI I Ie Bldg. Perrrrit Fee ~ ~ Sewer Unit .
, i;i~ Street Area .
Mate Surcha?ge........ .
Metro S-A£-Charge Park Fee ~ •
TOTAL PAID..
BUILDING PERII~IT Other.
Receipt ~ 3,03
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Permission is hereby granted to< a~ ~~ra Q~x~;^~ t?a~~~~}
Building oh Lot No. ~ j Block ~ ~ ~ ~ Subdivision T?~rzna9 s ~ YID.=t f i~~ ~::}a_rk irst?z ~
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Parcel No. ~
in the CITY OF LAKEVILLE to be used as ~ ° T''•'a'f ` ~~r-~.c t' ~+~s'~~,~ kutl l.d~.."t
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This permit is issued on the expressconditionthatthe ERECTION= ALTERATION REPAIRS
~ ENLARGEMENT .MOVING DEMOLITION respects to the statements. certified to in the
i application for such permit, and that all work shall be dA~ in~~cordance with the Ordinance of LAKEVILLE, Minnesota and
the State of Minnesota pertaining to the construction of buildtfigs. -
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StreetAddress ' `-.~L:~ f; ~~~t.b'aa< ~~t +~.,rt~t t>t~~i.~ ~a,+4=
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~ Director, Licenseand Inspection
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Call for inspections - 469-4431. BY ~ ° ~ ~ ~ -
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BUILDING PERMIT APPLICATION
ONE AND TWO FAMILY RESIDENTIAL
CITY OF LAKEVILLE
INSPECTION DEPARTMENT
8747 208TH STREET W.
P.O. BOX 957
LAKEVILLE, MN 55044
469-4431
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DATE : _ ~ ` ~
JOB SITE ADDRESS: ~e'~_
LEGAL DESCRIPTION: L/O~T: BLOCK: SUBDIVISION OR SECTION:
OWNER: ~~~~'~~~!1 PHONE:
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STREET ADDRESS: ~ ~~E~~ ~ ~3,:6~~`;-~
;1 CITY: ~~'~1,/'~'},`}t,C~i'~~ ZIP: ~,~~(a
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CONTRACTOR: ~jr ~l? ~ PHONE: ~.j ~ ~ ~ ~
STREET ADDRESS: CITY: ZIP:
CLASS OF WORK: NEW~~ ADDITION: ALTER/REMODEL: DEMOLISH:
PROPOSED USE ESCRIBE IN DETAIL) : Y~ ~~p ~~~Q
VALUATION OF WORK (EXCLUDING LAND):
I HEREBY APPLY FOR A BUILDING PERMIT AND I ACKNOWLEDGE THAT THE INFORMATION
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 PERMITS
AND THAT THE WORK WILL BE IN ACCORDANCE WITH THE APPROVED PLAN.
Applicant's Si natu e: FOR CITY USE ONLY
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Permit Fee $ ~
Plan Check $
Building Official 's Signature: y
Surcharge $ ~ ~J,~~
L' ~ ~ w_.~x .f/ Date: ~v~~,/,~~` SAC $
Comments: ` b~b
S/W Units $
Sewer Area $
Park or Misc. $
TOTAL DUE $