HomeMy WebLinkAboutLA106609 PERMIT
City of Lakeville Permit Type: Building
20195 Holyoke Ave Permit Number: LA106609
Lakeville, MN 55044
(952) 985-4440 * L R 1 6 6 >?1 9
www.ci.lakeville.mn.us Date Issued: 06/26/2008
Site Address: 16879 Dynamic Dr
Lot: 001 Block: 002 Addition: Spirit of Brandtjen Farm
PID: 22-71300-010-02
Use:
*22-7 13(~PJ-(~ 1(~-(~Z*
Description:
Sub Type: Lower Level -Residential Construction Type: V-B
Work Type: Alter/Remodel
Description: Family, fireplace, bed,bath, flex, future bar
Census Code: 434 - Addition/Bsmt fln/Decks/Porch Occupancy: IRC-1
Zoning: PUD
Square Feet: 0
Comments: LOWER LEVEL FAMILY ROOM W/FIREPLACE, (1) BEDROOM, FLEX ROOM,
WITH FUTURE BAR, BATHROOM.
Fee Summary: Descrintion Amount Revenue Code
Valuation: 10,000.00 1997 UBC Permit Fee $181.25 1000-4151
Electrical Addition/Remodel Fees $40.00 1000-4167
Surcharge -Based on Valuation $5.00 1000-2127
Total: $226.25
Contractor: -Applicant - OWner:
SEVERSON HOMES INC Stephen P Marsden
' 10531 t 65TH ST W 16879 Dynamic Dr
LAKEVILLE MN 55044 Lakeville MN 55044
(952) 898-1000
I HEREBY AGREE THAT THIS WORK WILL BE PERFORMED ACCORDING TO: (1) THE APPROVED PLANS &
SPECIFICATIONS; (2) THE APPLICABLE CITY ORDINANCES & CODES; AND (3) THE MN STATE BUILDING CODE.
I
Applicant/Permitee: Signature Issued By: Signature
Office Use Only
• RESIDENTIAL BUILDING ~
PERMIT APPLICAT)~ON permit Number
J ~ CITY OF LAKEVILLE
/ ~ BUILDING INSPECTIONS DEPARTMENT ~ Recei d By
- 20195 HOLYOKE AVENUE ,,t f~ J
\ % LAKEVILLE, MN 55044 a/1 ,~'C ` _ ~ ~ ~ - ~ 1 ~ ~l I Iv`
952-985-4440 W Date Received_
www.ci.lakeville.mn.us ~ ~1 ~ ~C~ :~L-'S
Fee Total
SITE ADDRESS: lG~7 ~ ~ Ir~~l~-
MAILING ADDRESS: CITY: STATE: ZIP:
JOB DESCRIPTION: /~iJ'S;~,~i~,~~ i S~
ESTIMATED VALUATION ~ Z' ' PROPOSED START DATE: END DATE: ~ /
(New Residential Only): LEGAL DESCRIPTION: LOT: BLOCK: SUBDIVISION:
APPLICANT IS: ? RESIDENT OWNER ~ CONTRACTOR
NEW MODEL HOME: ? YES ? NO IF YES -ADMINISTRATIVE PERMIT REQUIRED ISD #
PLEASE FILL O,U~Tr2THE FOLLOWING COMPLETELY
NAME: t
RESIDENT OWNER ~y
HOME PHONE ~G ~ - ~~3~~ CELL PHONE:
GENERAL CONTRACTOR CONTRACTOR: ~ ~ ~ /r~L ; LICENSE BC
? Homeowner OFFICE PHONE " /G'r~ t) CELL PHONE:
Contractor ADDRESS:~~~~~ / ~~i, ~ CITY: L,~:.l~ra? ST: ,~~ZIP: ~ d -
ELECTRICAL WORK CONTRACTOR: 1-`~./~i~iCIC f~L'$~, LICENSE CA C~' ~(1 /
? Homeowner * OFFICE PHONE 6~3 z ~ CELL PHONE:
Contractor ADDRESS: J~~~ !r~/V~?L~i~°,~(~'Y: ~~L¢ ST: ZIP:
*u Single Meter on individual unit Meter Bank at end of building (Requires licensed electrician.)
PLUMBING WORK CONTRACTOR: ~~~~~r~'~~ ~,~ILi/?~ LICENSE PM_ ~'~~y-
? Homeowner OFFICE PHONE ~~7 3~1 CELL PHONE:
Contractor ADDRESS: j~~~'U J~~~ ~~~5 CITY: ~~T: ZIP:
MECHANICAL WORK CONTRACTOR: ~/~t~~o`~ ~-1~Z~Z
? Homeowner OFFICE PHONE ~ /t~ ~~I3 ~ CELL PHONE:
Contractor ADDRESS: ~f Z~ f ~ CITY: ~'Jq--t/.L- ST: ZIP:
SEWER/WATER CONTRACTOR NAME:
New Construction Only HOME PHONE CELL PHONE:
INTEREST EARNINGS ON THE ESCROW ACCOUNTS, IF ANY, ARE RETAINED BY THE CITY TO OFFSET THE
ADMINISTRATIVE COSTS ASSOCIATED WITH PROCESSING THE ESCROW APPLICATION AND REFUND. I HEREBY
APPLY FOR A BUILDING PERMIT AND. I ACKNOWLEDGE THAT THE INFORMATION ABOVE IS COMPLETE AND
ACCURATE; THAT THE WORK WILL B IN CONFORMANCE WITH THE ORDINANCES AND CODES OF THE CITY AND
WITHT THE STATE BUILDING CODE, THAT I UNDERSTAND THIS IS NOT A PERMIT AND WORK IS NOT TO START
WITHOUT A PERMIT AND THAT THE WORK W B A CORDANCE WITH THE APPROVED PLAN
NAME OF APPLICANT (Please Print) f ''®,!i'~ DATE ~o ~ 2 ~
APPLICANT'S SIGNATURE:
RESIDENTIAL BUILDING PERMIT APPLICATION PAGE 2
OFFICE USE ONLY
BUILDING PERMIT TYPE REpUIRED INSPECTIONS
SINGLE FAMILY DWELLING BUILDING
DUPLEX FOOTING
TOWNHOUSE UNITS POURED WALL
DETACHED TOWNHOUSE UNIT GARAGES
CONDO FOUNDATION
ACCESSORY BUILDING FRAMING
REROOF LATH
RESIDE _~FIREPLACE
RES ADDN/REAIR/RMDL ~(~INSULATION
DECK DECK FOOTING
PORCH PORCH FOOTING
_~LOWER LEVEL FINISH BUILDING FINAL
ADDITION _~LOWER LEVEL FRAME
FOUNDATION ONLY SITE
MISCELLANEOUS OTHER
UNDEFINED WELL SEAL
DEMO SEPTIC TANK REMOVAL
MOVED ~ ~~p~
$ ~ ELECTRICAL
CITY B DING VALUATION ROUGH-IN
TRENCH
BUILDING PERMIT FEES _~FINAL
$ PERMIT FEE MECHANICAL
$ PLAN CHECK ROUGH-IN
$ s . d0 SURCHARGE FAIR TEST
$ METRO SAC FINAL
$ CITY WATER HOOKUP UNIT PLUMBING
$ CITY SEWER HOOKUP UNIT X ROUGH-IN
$ LANDSCAPE ESCROW FINAL
$ TREE ESCROW METER SIZE
$ MISC ESCROW PRESSURE REDUCING VALVE
' $ y , d0 ELECTRICAL SEWER AND WATER
$ PLUMBING ~ FINAL
$ MECHANICAL STREET DRAINTILE
$ SEWER & WATER
$ OTHER B 7ILDING INFORMATION
TYPE OF CONSTRUCTION
S-~ ~ as TOTAL ZONING
~~_CODE EDITION
APPROVED BY: FIRE SUPPRESSION SYSTEM
D OCCUPANCY GRO
BUILDING INSPECTOR: `~IQ~}~- ` -~;~`S~~r~, DATE: g
PLUMBING/ME/CHANIC/A_L INSPECTOR: DATE:
COMMENTS: ! U ~G,~ iiO/'2~ ,/K ~
~ ~ d-~t~K~? ~ bar . b~H'#'a. 2.x'1,
(Revised 03/26/2007)