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CITY OF LITTLE <br />CANAUA <br />515 Little Canada Road, Little Canada, Minnesota 55117 <br />484-2177 <br />DO NOT WRITE IN THIS SPACE <br />BUILDING PERMIT NO. <br />Name :`�' '� >�-'� v Y v- <br />Permit Fee .......... ....... ...... <br />. $ <br />. <br />cc . � �,� � • � (L�.�t <br />State Surcharge ... ........... <br />.. $ <br />a Address ; . <br />$ <br />-- I-� r, .J Tel. No.e.�y� c� } <br />City�' 7- <br />Plan Check Fee ................... <br />. <br />"Fip <br />SAC Charge ( Units) <br />$ <br />o Name <br />$ <br />Other ................ ...... <br />0 Q Address <br />$ <br />U Tel. No. <br />City zip <br />�- cr Name <br />w <br />Penalty ......... . ... . ............ <br />$ <br />w <br />H Z Address <br />— <br />Tel. No. <br />TOTAL FEE PA I D ...... • • <br />' • . $ <br />V 21p <br />It Z City <br />w <br />Receipt No. <br />Date <br />Q <br />Registration Number <br />DEMOLISH <br />BUILD ADD ALTER <br />REPAIR MOVE <br />Lj <br />tructure _ <br />Ised As '�� i ,,• . -_ -' Zone r <br />l__ <br />_ <br />LOT BLOCK ADDITION OR TRACT <br />NUMBER STREET <br />_`7 ! < . ice- •t- <br />/ <br />' LEGAL DESCRIPTION <br />SIDE YARD <br />SETBACK FRONT YARD SETBACK <br />WIDTH DEPTH <br />LOT <br />SIT <br />HEIGHT <br />TYPE OF CONSTRUCTION <br />ESTIMATED VALUE <br />WIDTH LENGTH <br />STRUCTURE l� q �,' J- / 4?.{�;`-�- <br />t• -, j` -7•� <br />DETAILS _ <br />VAL FOR SURCHARGE <br />DETAILS OR REMARKS: <br />NOTICE <br />DO NOT WRITE IN THIS SPACE <br />SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, <br />Type of <br />ConsI <br />Occupancy Jw a:o• <br />Grout) <br />PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR <br />AUTHORIZED 1S NOT COMMENCED WITHIN <br />S`zeof Bldg <br />(Total) Sq. Ft <br />No or Ma <br />Storses OCc Load <br />CONSTRUCTION <br />IF CONSTRUCTION OR WORK IS SUSPENDED OR <br />120 DAYS,OR <br />ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME <br />F1fQ — <br />uS, F,reSp, inioers <br />Recuireo Yes No <br />AFTER WORK IS COMMENCED. <br />Zane <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />ORDINANCES <br />No. of <br />Units <br />OFF STREET PARKING SPACES <br />CORRECT. ALL PROVISION OF LAWS AND <br />THIS TYPE OF WORK WILL BE COMPLIED WITH <br />Dwell,,,g <br />Cote'eo <br />i��cnered <br />GOVERNING <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />ReQu red Receivert Not Requ�reo <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />ANY OTHER <br />Special Approvals <br />VIOLATE OR CANCEL THE PROVISIONS OF <br />CAL LAW REGULATING CONSTRUCTION OR THE <br />BOARD OF APPEALS <br />- <br />STATE OR <br />PERFORMANCE OF CONSTRUCTION. <br />PLANNING COMM <br />VILLAGE COUNCIL <br />I <br />SIGN A RE OF CO IRAC 0 OR AUTHORIZED AGENT (DATE) <br />SPECIAL <br />__ <br />L,as'� �, %�. <br />l <br />FIRE DEPT <br />----- __— <br />,} , <br />- (GATE) <br />•SIG ATUR F OWNER (IF OWNER BUILDER) <br />SOIL REPORT <br />- -�--- <br />PERMIT ISSUED <br />OTHt R <br />Rqg <br />BUILDING OFFICIAL (DATE) <br />CLERK"S EXHIBIT NO <br />tiIeeting 10-13-76 <br />