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<br />CITY OF CENTERVILLE, MINNESOTA
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<br />Permit No. ( )).
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<br />Owner: (" (J ..,'" \ ) hr\r? '
<br />Address \ 'r< /'\ \ in 1\ \ 1\)
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<br />Builder
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<br />Address
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<br />11)1111 '\ E.~Yt~_ (' hLt LOCATION OF PROPOSED BUILDING L/i .c:) 3 7': ....,~
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<br />Zoning Classification Number , Street
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<br />Part of Lot
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<br />Lot
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<br />LEGAL DESCRIPTION
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<br />Block
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<br />Addt'n or Sub-Diy.
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<br />DESCRIPTION OF PROPOSED WORK
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<br />No. of Stories:
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<br />'lYpe of Construction:
<br />Occupancy
<br />Valuation $
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<br />Area:
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<br />(Lllrgest Horizontal Cross Sectionl
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<br />. (Contract of Murket Value)
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<br />VARIANCES
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<br />Description of Ordinance Variance(s) if granted with this permit
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<br />Parks Residential Equiv, Water Meter Storm Sewer Mailbox Other Total
<br />Unit (REU)
<br /> Water Hookup S.A. C. Site Maintenance
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<br />CITY FEES
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<br />Fee Per Schedule Surcharge Totals
<br />Permit Fee IV (' Nf N ( ,,'
<br />Plan Review ~, '
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<br />PERMIT FEES
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<br />Pe':1llissio~ i,s hereby granted to "-l t-r Y') l~~:' t <.......:) I {_.~!j --'1. (0 { (-t, 'r'""" L) ~'").;'l..t~ I .:."' -J . . a building as terein describet:l,
<br />ThiS permn IS granted upon the express con~ltlOn that the persclO, partnership, firm or cOl'poratlOn to who tt IS granted, (ogetner WJth hiS agents, employeees, workmen and
<br />subcontractors agree to abide by and conform to all Ordinances of the City of Centerville regarding the construction, alteration, maintenance, repair and demolition of buildings
<br />within the City; and that this permit may be revoked at any time upon evidence of violations of any of the provisions of said Ordinances.
<br />
<br />Issuance of a budding permit is not 10 be construed or relied upon as a warranty, guarantee, or representation on the part of the City that the construction or finished product
<br />cqvered under this building permit is, necessarily in conformation with the state building code or other applicable construction standards. The City assumes no responsibility or
<br />liability for damages arising out of the issuance of this building permir.
<br />
<br />The perm'{te furrl!e ~~rees fO, commence the work covered by Ihis. permit withi~ sixty (60) days of t~e date hereof and to cD~plete all su~h work: .by
<br />J_.~ ) t I , SuspensiOli or abandonment of such work for a penod of one hundred and eighty (180) days shall result In the automatic revocation
<br />emit as pr9vided by rdin~nce.
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<br />By:
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