HomeMy WebLinkAboutNo 12004 :.l
~1 ~ City of Lakevi I le
~~;~w_5.,':~1 INSPECTION C~EPARTMEN7
2~~. ~i? BUILDING PERMIT Valuation ~c,nc-~,,,;~
5~~~i.vls ,~~.C'~r"Qr'.b ~rla,t_ Fd. BuildingPermttFee
Receipt ,
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7u?~i.~:s `w'z~~:~;. ttrf.:` State Surcharge
TOTAL FEE PAID ?tt7~= _ Cf(}
Permission is hereby granted to
Building "on Lot No. ~ Block ~ Subdivision ~}tlilt'i~~S ~ Palk Aririp~
Parcel ;~`~2-G~:1fi7-023-~~ Plat
€ in theClTY OF LAKEVILLEtobeusedas ~'~~'T~.'' Cc~ts~t'rtt^t €s~ngln f~.sr ^~4rrs14ir~ ~ 14tre.~g7 'E~~ffi~.a2
This permit is issued on`the express condition that the ~r~
ERECTION -ALTERATION REPAIRS
__~NLARGEMENT -JIAOVING DEMOLITION`respects to the: statements certified to in he applica#ion for
such permit, and hat all work shall be done in accordance vvith the Ordinance of LAKEV1l.LE, Minnesota and the State of Minnesota
'.pertaining to the construction of buildings..
Street Address 7 F ~ ~ ti 'Sd ~s~~~7 ~ ~ ri ~R~ "i a
Director, License and Inspection
Attention is particularly called to the cutting up of streets, making main sewer
Connections, driveways and curbs. Obtain permit for suchconstructionfromtheClTY ~r '
OF LAKEVILLE. Inspection Department Not Responsible For Any Damages to By ~
publiatltilities. -
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APPLICATION FOR BUILDING PERMIT
CITY OF LAKEVILLE
8747 208th St. W. P.O. Box M
Lakeville, MN 55044
..469-4431
Job Site Address : ~
~
r C~
Leq scription: Lot Block ~ Addition
Owner Phone
Rddress
Contractor • Phone~,~~~~
Address
Class. of Work : Erect ( ) Aiter ' ( )Repair ( ) Enla e ( )Move ( ) Demolish
Propose8 Use (Describe in Detail) ~~i~,~%,1 r~ ~g~
Heating Contractor n~,~./~~~ L~
Pluaibinq Contractor ~~?C~~~~ 0~~~~~"g'~~~C=~G°r
Sewez & Water Contractor
Electrical Contractor
Special Conditions
Valuation of Work.: S_ , ~
Signature of Applicant & Title: FOR CITY USE ONLY
Zone
City Fee S r~~~. c?
• Signature of Zoning Officer: Surcharge S ~
~R
SAC S ~
I
Hook-ups S ~ -
, Date
Area Charge S
Signature of Building Inspector:
Other S
~ Total S
Date