HomeMy WebLinkAboutNo 12244 T'j
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~ ~ City of Lakeville
INSPECTION DEPARTMENT
_ BUILDING PERMIT Valuation `ij~` ~
. _ , & f~@C@I pt Building Permit Fee ~ ~ ~~t
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State Surcharge ? `3 a i)i
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TOTAL FEE PAID ~ •
Permission is hereby granted to ~rr' ~ ~ $ ~ r-+' `c ~ '
v « y ~y, , ~r nr.. ~
Building on Lot No. ~ ' Block ` Subdivision `a:~.a ` ~"T ~ ~f'"~~`
Parcel _ , ;r...v Plat
in the CITY OF LAKEVILLE to be used as
This permit is issued on, the express condition that the -:;~~RECTION -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.
. '
Street Address
Director, License and Inspection
Attention is particularly called to-the cutting Up of streets, making main sewer
connections, drivewaysandcurbs. Obtain permitfor such construction from the CITY
OF LAKEVILLE. Inspection bepartment Not Responsible For Any Damages to By
Public Utilities.
AFPLICATION FQR B I~,DSNG PERMIT
r ~ CITY OF LAI • VILLE~
8?47 208th St. W. P.O. Box M
Lakeville= MN 55044
~ ~J 469 4431
Job Site /Address : L
Legal Description: Lot ••Block Addition _
Owner _ Phone
Address /
Phone 7`'Jr~" 1~.1~`~'-.~
Contractor
Address
C3ass of Work: )Erect ( )Alter ( )Repair ( )Enlarge ( )Move ( ) Demolish
Proposed. Use (Describe in Detail) ,®~!e~ ~~a`
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Eleat'inq Contractor
Plumbing Contractor ~ '
Sewer & Water Contractor
Electrical Contractor ~ ~/~ic»
Special Conditions
Valuation of wozk : S ~ d ~
Signature of Applicant & Title: ~ FOR .CITY USE ONLY
Zone
City Fee $ `L
Date l9 Plan Ch+e~k S
Signature of Zoning Officer: Surcharge S ~ ~ A'~
SAC 5~,~ ~
a.,
Hook-ups 5 ~
Date
Area Charge 5 r.~
r
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Signature of Building Inspector:
Other S
Total S `
Date
L