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CITY OF LITTLE CANADA <br />515 Little Canada Road, Little Canada, Minnesota 55117 <br />BUILDING PERMIT NO — 'A-6 484 -2177 <br />DO NOT WRITE IN THIS SPACE <br />Name / � tot! <br />7751 ;rii!. <br />Address 72 K✓ +2k * „�--- <br />City <br />y <br />Zip Tel. No. <br />Name H-1/4 0-441,/, �Ce ,/ JG,cTc! <br />Address <br />city :� t77_ °-/5;,.„414.1. <br />Tel. No. <br />Name <br />Address <br />City <br />Zip Tel. No. <br />Registration Number <br />Permit Fee <br />State Surcharge <br />'4( a <br />4 3C <br />Plan Check Fee ? <br />4L // <br />SAC Charge (Units) .5" 3 / D <br />Sewer <br />Water <br />Park <br />r GT? -$77 6 <br />sv -- if$i0 <br />Other $ <br />Penalty $ <br />TOTAL FEE PAID $ <br />Receipt No. Date <br />`; i <br />Structure , Used As �/ �i'%• ��1- 4 •� FJ S t _one <br />DEMOLISH <br />0 <br />BUILD <br />ADO <br />ALTER <br />0 <br />REPAIR <br />0 <br />MOVE <br />NUMBER <br />WIDTH <br />DEPTH <br />STREET <br />LOT <br />BLOCK <br />LOT <br />SIZE' <br />ADDITION OR TRACT <br />3/7 '—..,;IL. <br />Jo <br />.1/4 <br />fi. i 1.l - <br />J <br />Required <br />/ I T 6i� <br />/,,, .✓ ?,�! /. 1Co„Cic .� <br />LEGAL DESCRIPTION <br />'47 C.4./n,�% <br />/ <br />NOTICE: Do Not Di #uth. ' - <br />Natural Drainage <br />DETAILS OR REMARKS: 0 Y Fio -ed q- <br />/be/Lige Ao% s.e <br />VAL FOR SURCHARGE <br />NOTICE <br />SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, <br />PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR <br />CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN <br />120 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR <br />. ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME <br />AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION ANO KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISION OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF•CONSTRUC N.i7 <br />SIGNATURE OF CONTRACTOR OR''AUTHORIZED AGENT (DATE) <br />SIGNATURE OF OWNER (IF OWNER BUILDER) <br />PERMIT, ISSUED <br />• BUILDING OFFICIAL <br />(DATE) <br />P <br />DO NOT WRITE IN THIS SPACE <br />Type of <br />Consl. /�� <br />J <br />WIDTH <br />DEPTH <br />SIDE YARD /SETBACK <br />SIDE YARD /SETBACK <br />FRONT YARD SETBACK <br />LOT <br />SIZE' <br />�_„ <br />Fire Sprinklers <br />Required °Yes GNo <br />No. of <br />Dwelling Units <br />OFF STREET PARKING SPACES: <br />Covered ', <br />Uncovered <br />Special Approvals <br />Required <br />Received <br />WIDTH <br />LENGTH <br />HEIGHT <br />TYPE OF CONSTRUCTION <br />ESTIMATED VALUE <br />STRUCTURE <br />DETAILS <br />CL.... <br />7C) <br />O''3— <br />��J <br />NOTICE: Do Not Di #uth. ' - <br />Natural Drainage <br />DETAILS OR REMARKS: 0 Y Fio -ed q- <br />/be/Lige Ao% s.e <br />VAL FOR SURCHARGE <br />NOTICE <br />SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, <br />PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR <br />CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN <br />120 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR <br />. ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME <br />AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION ANO KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISION OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF•CONSTRUC N.i7 <br />SIGNATURE OF CONTRACTOR OR''AUTHORIZED AGENT (DATE) <br />SIGNATURE OF OWNER (IF OWNER BUILDER) <br />PERMIT, ISSUED <br />• BUILDING OFFICIAL <br />(DATE) <br />P <br />DO NOT WRITE IN THIS SPACE <br />Type of <br />Consl. /�� <br />J <br />Occupancy ;// <br />Group ,( /Jf <br />Division <br />:. <br />�+M <br />Size l)Sq. Ft. <br />(Toted Sq. Ft. <br />No.ie <br />Storba <br />Max. <br />Occ. Load <br />Fire <br />Zone <br />Use <br />Zone <br />Fire Sprinklers <br />Required °Yes GNo <br />No. of <br />Dwelling Units <br />OFF STREET PARKING SPACES: <br />Covered ', <br />Uncovered <br />Special Approvals <br />Required <br />Received <br />Not Required <br />BOARD OF APPEALS <br />PLANNING COMM. <br />VILLAGE COUNCIL <br />SPECIAL USE <br />FIRE DEPT. <br />SOIL REPORT <br />....Lc CO <br />lae 15 <br />