HomeMy WebLinkAboutNo 12440 1
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City of Lakeville
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INSPECTION DEPARTMENT j3I
t~ ).;;t~ t.=~~:~~ ~jn~~ ~~BUILDING PERMIT Valuation
* ~ , ~t~w€~~ E zl _ t ~c~ . & ReCel pt Building Permit Fee 3 • ~
State Surcharge
TOTAL FEE PAID ;
Permission is hereby granted to Jrs"-'r' ~ ``1 x7~E~r +"i'+n , ~i~iC
~:1 i)csrt*tv~4~s C1~11.~u ~FS~~t i3~:Yi
Building on Lot. No. ~ Block Subdivision
..Parcel ,F ,a 5 ' 177y2 ~i._.-~~ Plat
zr;~R ~.s
in fheCITY OF LAKEViLLEtobeusedas 1'Erf~'" ta) r` ° z~~~ ~~-Ttr , c=. ~"~r~.i.tr ~FnTf?.~1~..r.~.,
This permit is issued on the express condition that the ERECTION ALTERATION -REPAIRS
_~NLARGEMENT 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 it~l~1: TrFirap~i,'r„~,taa~ Girl P~ii17~-.r
Director, License and Inspection
Attention is particularly called to the cutting. up of'streets,'making main sewer,
connections, driveways and curbs. ObtainpermitforsuchconstructonfromtheClTY y
OF LAKEVILLE.lnspection Department Not Responsible For Any Damages to By
Public Utilities. ~ a ' `
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~ APPLICATION FOR BUILDING PERMIT
~ ~ /'i _ CITY OF LAKEV2LLE
8747 208th St, W. F.O. Box M
Lakeville, MN 55044
UU 4 9-4431
Job Site Address : ~
Lega cripton: Lot Block Addition
Owner Phone
Address
Contractor Phone !~5,$~~~
F
Address ~ ~
Class of Work . Erect ( )Alter ( )Repair ( )Enlarge ( )Move ( ) Demolish
Propose8 Use (Describe in Detail) ~
Heating Co~stractor
Plumbing Contractor ~~f,.
Sewer & Water Contractor
Electrical Contractor ' ~ .
Special Conditions
Valuation of Work : S ~ ~1 ~ ~ ~
~ ?
Signature of Applicant & Title: FOR CITY. USE ONLY
~ ~ ~~'~~"".~~i~ Zone
City Fee S ~ ~ .
Here D '~T _ Plan +Check S
Signature of Zoning Officer: Surcharge S ~
SAC S ~ ~ ~
Hook-ups S ~ .
Date
Signature of Building. Inspector: Area Charge S ~
Other S
r ~ ~
Total S ` C.~. l~e''/
Date