HomeMy WebLinkAboutNo 13879
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Valuation.. ~ x 204. ~(3 Water Unit
Clty Of Lak@VI~~e Bldg. Permit Fee .Sewer Unit
State Surcharge 1, Street Area .
Metro SAC Charge , Park Fee .
BUILDING PERMIT Other TOTAL PAID......... ~ 21,511
Receipt
P~u1 rcus, t)c~~~r
Permission is hereby granted to
Building oh Lot No. Block Subdivision. ~?onrza~ } ~ tla~ ley w ark nth Ads3tt.
Parcel No. );~-X1177-L~=.~--147
in the CITY OF LAKEVILLE to be used as Pez~uit tC~ ~cs»ist"~ttet; 1~ 1~ foot cI+e~ck
This permit is issued on theexpresscondition thatthe 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 o the construction of buildings.
Street Address 131 ~'ant~s:~.s .Av~rstaP. 1'3.~~~3.d I~ri°~,~~
Director,licensesnd Inspection
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
DATE : ~ ~ C~
' JOB SITE ADDRESS : ~~.j U! ~ ja
LEGAL DESCRIPTION: LOT: BLOCK: SUBDIVISION OR SECTION: ~h~a 'S ;,i~I~
OWNER: ~ ,U " PHONE : //,j ~ J~
STREET ADDRESS: ~ ~ qy~, ~a ~ CITY: (7~~Yh~~~,r~,~'~" ZIP: Q~p
CONTRACTOR:. ~~Ct.~`C.~~ PHONE: ~c~yh.(s
STREET ADDRESS: CITY: ~:~n~.aZ ZIP: -~q~
CLASS OF WORK: NEW ADDITION: ,ALTER/REMODEL: DEMOLISH:
PROPOSED USE (DESCRIBE IN DETAIL): ~ ~
VALUATION OF WORK (EXCLUDING LAND) : ~I ~ C~G..~~,
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 PERMTT;
AND THAT THE WORK WILL BE IN ACCORDANCE WITH THE APPROVED PLAN.
Appl'cant's Si ature: FOR CITY USE ONLY
Date: Zane
Permit Fee $ .
Plan Check $
Building Offici 1 `s Signature:
p- Surcharge $ ~
i !i' ~ Date: ~~-D
SAC $
Comments:
S/W Units $
Sewer Area $
Park or Misc. $
TOTAL DUE $ `~C