HomeMy WebLinkAboutNo 11700 6 City of Lakeville s
INSPECTION DEPARTMENT
$'s25 i`~~ SAC ~d.
T~~~.~.~ '~alre>' vriiC ~~.BUILDING PERMIT Valuation
S~+S . 0:1 ::"e~;~r Uzt.ifr -~'d. Sc ReCel pt Building Permit Fee .2$3.50
Z":5. JO Se~~x ~r~a ~°d. 25.0
State Surcharge
TOTAL FEE PAID .T3~?9.00
Permission is hi?reby granted to ' t;b?~aSi ° * ~riC
Building on Lot`No. ~ Black ~ Subdivision n•~-~++~Y~Q ire ~ > ~r ` aN,.t. - tt..~., a a,~ri
Parcel~}22-21177-01')--i~+~, Plat
in the CITY OFLAKEVILLEtobeusedas Pe>•'mit tt's rr,satrt~ri- ~in~im fnm~t~ ~Sr;~~~~lE'ta°
This permit is issued on the express condition that the ERECTION -~4LTERATION REPAIRS
`ENLARGEMENT -JIAOVING -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 1fi377 ~'aYC~; W~~ Sici Mi11`r
Director, License and Inspection
Attention is particularly called to the cutting up of streets; making main sewer f r
connections, driveways and curbs. ObtainpermitforsuchconstructionfromtheClTY
< .l
OF LAKEVILLE.- Inspection Department Not Responsible For Any Damages to By ~-+f"'~-^'" ~ w
Public Utilities.
A 1
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APPLICATION F3 BUILDING PERMIT
CITY OF.LAKEV~LLE
8747 208th 5~. Pnl. P.O. Box M .
Lakeville, MN 55044
6~3 -4431
Job Site Address; ~
Legal. Description; Lot •Bloek~_Additon
Owner Phone 3".~
f` ~~5~
Address. 3~
Contractor hone S~
Address ~~~33 ~i~~~~~ ~J F
Class of Work: )Erect ( )Alter.. ( )Repair ( )Enlarge ( )Move ( l Demolish
Proposed Use (Describe in Detail) if~~ Szs~~~-J
Heating Contractor
Plumbing Contractor_~~~~~SG
Sewer & Water Contractor
Electrical Contractor z
Special Conditions
Valuation of Work.: $ ~ ~ ~~Jd
Signature of Applicant & Title:. FOR CITY USE ONLY
Zone
City .Fee S f ~ ~
~
T
Date Plan Check S ~ ~ Ur
Signat e o inng leer: Surcharge $ ~
/ SAC S ~ 4'~
Date Hook-ups $ G~ d
Area Charge S ~ ~ ~ ~S
Signature of Building Inspector:
Other
Total S~
Date