HomeMy WebLinkAboutNo 12416 7„~,~r Vii? , 19~i
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ti 4 ~ ~ City of Lakeville
$425.G~t: ~~~c INSPECTION DEPARTMENT
7f~!;,~1' Wz3ter t?~,i~ Pd,BUILDING PERMIT Valuation ~,.~~~-r
rJ'75,~~ JPYO'~~:r ~il~.t; Pd. LQrJ...~Y}.
1.3$. ()C~ ;t ~;~r tlr~ca Pd , gc Re'cei pt Building Permit Fee
State Surcharge ~ ~
tOTAL FEE PAID 3.°'~fJ
Permission is hereby granted to :.fo:~~ptt h111.1er ~ott~~.
Building on Lot No: `t Block b Subdivision T)nrsrrA~,g+ Va.] i r?~ A`~~-~ ~R-~-Arlr~t?
Parcel ~2?_°-~~ ? ! -Q3C;-'~k~ Plat
in theClTY OF LAKEVILLEtobeusedas tc+ cc~^~trrat*t t;j.lo f~mil~r dw~71'n~
This permit ?s issued on the express condition that the 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 LAKEV?LLE, Minnesota and'the State of Minnesota
pertaining to the construction of buildings.
Street Address ~ i,L~y~~;. sf~~ S~.d Miller _ _ -
Director, License and Inspection
Attention is particularly called to the cutting up of streets, making main sewer.
connections, driuewaysand curbs. Obtam permitfor such construction from the CITY
OF LAKEVILLE. dnspection Department Not Responsible For Any Damages to' By r
Public lJtilities.
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APPLICATION FOR BUILDING PERMZT
CITY OF IdUCEVILLE
8747 208th St. W. P.O. Box M
Lakeville, MN 55044
r~469-443,.1
Job Site Address : / (.(o~(~"/ ~~°C~ f~~
Legal Descriptions Lot ~ • •B1ock~Addition (~~~.'~~i
Owner Phone
Address
Co»tractor Phone 'f~
~ r- 5' %~S3
Address T
Class of Work : ~ Erect ( )Alter ( )Repair ( )Enlarge ( )l~love ( ) Demolish
Proposed Use (Describe in Detail) 5~~/~~/
Heating Contractor ~2i~~-~L
Plumbing Contractor i~ /L-~ ~L~j-ri _ _ _ _ /
Sewer & Water Contractor
Electrical Contractor
Special Conditions
Valuation of Work : S f. t
Signature of Applicant Z Title: ~ FOR CITY USE ONLY
Zone
City Fee S
Date _ Plan Check S
Signature of Zoning Officer: Surcharge S ~
SAC S~ ~ }
. Date ~ Hook-ups 5 ~ ,
Signature of Building Inspector; Area Charge $ p( ,
Other 5
5 .F ~ 'f,
~
Total S ~ x~
Date