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<br />BUILDING PERM'IT
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<br />O?,ner:
<br />. Address
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<br />CITY OF CENTERVILLE, MINNESOTA
<br />. Q0 ()""\
<br />Permit No,' . ') - '.::> .",t..
<br />
<br />Builder
<br />
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<br />
<br />~-,
<br />--~R' .....
<br />
<br />Address
<br />
<br />LOCATION OF PROPOSED BUILDING
<br />
<br />:I'
<br />
<br />Zoning Classification
<br />
<br />Number
<br />
<br />Street
<br />
<br />Part of Lot
<br />
<br />
<br />LEGAL DESCRIPTION
<br />Lot Block
<br />/ 2-
<br />DESCRIPTION OF PROPOSED WORK
<br />
<br />. . Addt'ri orSub-Div, .
<br />/-"!"':'Nkr? (L~--C-";;;'"
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<br />.: .~: .
<br />
<br />"J'
<br />
<br />
<br />;b~~~~~qri: A ~~~I "'{n~
<br />~'-, ," '..,.:.. At .
<br />,'TiPo' Of Construction: . . ~_dfi7-k;/
<br />" .. ..' ';e. .
<br />. "~Bf;cf~~OY ',~
<br />.... .~: Su. .,v,
<br />:iSOtuatlon $ ~ .' .>. r "-,
<br />~'i'r. ; .
<br />
<br />No. of Stories:
<br />
<br />Area:
<br />
<br />. .
<br />'. (t~ntracJ. 'of M~ke~ V~ue)
<br />
<br />~g~f Hqrizontal CrOS$ Sectiei~)
<br />
<br />VARIANCES
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<br />)';' 'i !'>escriptionofOrdinaOCe Variante(s) if granted with this permit:
<br />it;;;.,,' ,'.' ;. - ,....,. . ".,
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<br />. .
<br />
<br />.
<br />
<br />-",t,
<br />.
<br />
<br />'."
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<br />
<br />."
<br />
<br />CITY !,'EES
<br />
<br />
<br />Residential pquiii, '
<br />Unit (REU)
<br />, 0J
<br />o
<br />. .
<br />
<br />'Water Myter
<br />
<br />:Sto~m Sewer
<br />
<br />Mailbox
<br />
<br />Other
<br />
<br />. Total
<br />
<br />,
<br />
<br />"~.9 fl. IV.
<br />
<br />'Water: HOOKUp'
<br />
<br />:::; ill!. #
<br />SAC.
<br />ll--tPt/.rv
<br />
<br />:~.
<br />
<br />? 47ttj-.
<br />
<br />Site'MaiI)tenanc~
<br />
<br />'.,
<br />
<br />J SiJO, iN
<br />
<br />'2 -
<br />
<br />"'~-?s:""'>'. 19~-: rl
<br />
<br />PERMIT FEES
<br />
<br />Fe~ Pe~ Sche~ul,~ '
<br />
<br />J 1,../"j,4:.>-
<br />
<br />"'" 7' 7')
<br />1 S 1."-,,7 .
<br />
<br />i ' .'. . . '. "" L. ''j .5 9~. f''/
<br />
<br />: 'ip~it?ls~o~ is he;~y granted to /..1-n-k~ ~i. . l~ to . _ {" ~1/";'.:C:ie~' , . a building as_herein descnoed.
<br />:TN~ pe-rrillt is granted upoll the eXpress conditiortth'at ,t:O~p'erson, partnership, firm or corporation to wh~ it is "granted, togemer with his agents, emp~oyeees, workmen ~d
<br />; sujJtpntractors agree. 1<;> abide by and conform to all Ordinances ofthe City of Centerville regarding the construction. ~teration. maintenance, repair and demolition of buildings
<br />..yi~ ~e City; and that this permit may ~e revoked at any time upon evidence of violations of ~y of the provisions of said Ordinances. .
<br />
<br />
<br />SUf~harge
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<br />Tota~~
<br />
<br />:23 S
<br />IS17.39
<br />
<br />/ 2. f.
<br />
<br />'oV'
<br />
<br />Issu.ance of a building permit is not to be construed or relied upon as a warranty, guarantee, or representation on the part of the City that the construction or fInished product
<br />covered under this building permit is nec.essanly in c;onfonnation with the state building code or other applicable 'construction standards. The City assumes no responsibility or
<br />. liability for damages arising out Of the issuapce of this bj.1ilding permit.
<br />
<br />. :T~~. p.ermittee fu~t-{er J.gre_e,s to commence the work covered by this permit within sixty (60) days of the date hereof ~nd to complete all such work by
<br />'. '!jf '-V , Suspension orabandonIl).ent of such work fora period of one hundred and eighty (180) days shall result in the automatic revocation
<br />of this pennit as provi ed. by Ordinance. . ' ..'/ i;1:
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<br />. , -'/-7JI' /\ PA/1 ~:2-
<br />~ PERMlTIEE I BUILDING INSPECTOR
<br />
<br />By:
<br />
<br />By,
<br />
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