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cc <br />w <br />w <br />2 <br />3 <br />cc <br />O <br />0 <br />0 <br />ZV <br />o <br />1- Q <br />UQ <br />WW <br />� W <br />0 <br />¢Z <br />Qw <br />CITYCOF LITTLE CANADA <br />515 Lit a Canada Road, Little Canada, Minnesota 55117 <br />i— '' y -^ 484217,7 L,�. - <br />BUILDING PERMIT NO. , , - i ,,ytr >3C/ fc/ DO NOT WRITE IN THIS SPACE <br />Name <br />Addressssl 2, ,7 4/�_. 3,223 <br />[ /7 Tel. No.7('i. Z <br />Name / f <br />�l5 <br />Address a /T��n <br />CIt ✓ ZIP Tel. No. <br />Y <br />Name <br />Address <br />City <br />Zip Tel. No. <br />Registration Number <br />Permit Fee <br />State Surcharge <br />Plan Check Fee <br />SAC Charge (Units) <br />Sewer <br />Water <br />Park <br />Other <br />Penalty <br />TOTAL FEE PAID <br />Receipt No. Date <br />Structure //A_ A4 am <br />Used As j i / r�one <br />DEMOLISH <br />❑ <br />BUILD <br />ADD <br />0 <br />ALTER <br />0 <br />REPAIR <br />❑ <br />MOVE <br />NUMBER <br />STREET <br />LOT <br />BLOCK <br />SIDE YARD /SETBACK <br />ADDITION OR TRACT <br />LOT <br />SIZE <br />Use <br />Zone <br />rte-- <br />No. of <br />Dwelling Units <br />OFF STREET PARKING SPACES: <br />Covered <br />,� / <br />, <br />// <br />Received <br />Gaya <br />LEGAL DESCRIPTION <br />NOTICE: Do Hot Disturb) DETAILS OR REMARKS: <br />Neural' Drcircge lU,�'i % _ . h`— 3 <br />tAL FOR SURCHARGE <br />IC; CPZ <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 AND 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 CONSTRUCTION. <br />4%117:1 //al ( <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) <br />SIGNATURE OF OWNER (IF OWNER BUILDER) <br />PEBMtT ISSUED <br />/ <br />(DATE) <br />BUILDING OFFICIAL <br />(DATE) <br />DO NOT WRITE IN THIS SPACE <br />Type of <br />Const. 5----,2„,/ <br />WIDTH <br />DEPTH <br />SIDE YARD /SETBACK <br />SIDE YARD /SETBACK <br />FRONT YARD SETBACK <br />LOT <br />SIZE <br />Use <br />Zone <br />Fire Sprinklers L' <br />Required CI Yes $p No <br />No. of <br />Dwelling Units <br />OFF STREET PARKING SPACES: <br />Covered <br />Uncovered <br />Special Approvals <br />NOTICE: Do Hot Disturb) DETAILS OR REMARKS: <br />Neural' Drcircge lU,�'i % _ . h`— 3 <br />tAL FOR SURCHARGE <br />IC; CPZ <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 AND 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 CONSTRUCTION. <br />4%117:1 //al ( <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) <br />SIGNATURE OF OWNER (IF OWNER BUILDER) <br />PEBMtT ISSUED <br />/ <br />(DATE) <br />BUILDING OFFICIAL <br />(DATE) <br />DO NOT WRITE IN THIS SPACE <br />Type of <br />Const. 5----,2„,/ <br />WIDTH <br />LENGTH <br />HEIGHT <br />TYPE OF CONSTRUCTION <br />ESTIMATED VALUE <br />STRUCTURE <br />DETAILS <br />Use <br />Zone <br />Fire Sprinklers L' <br />Required CI Yes $p No <br />No. of <br />Dwelling Units <br />OFF STREET PARKING SPACES: <br />Covered <br />Uncovered <br />NOTICE: Do Hot Disturb) DETAILS OR REMARKS: <br />Neural' Drcircge lU,�'i % _ . h`— 3 <br />tAL FOR SURCHARGE <br />IC; CPZ <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 AND 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 CONSTRUCTION. <br />4%117:1 //al ( <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) <br />SIGNATURE OF OWNER (IF OWNER BUILDER) <br />PEBMtT ISSUED <br />/ <br />(DATE) <br />BUILDING OFFICIAL <br />(DATE) <br />DO NOT WRITE IN THIS SPACE <br />Type of <br />Const. 5----,2„,/ <br />Occupancy <br />Group <br />Dlvision� <br />Size of Bldg. <br />(Total) Sq. Ft, <br />dvz) <br />No. of <br />Stories / <br />Max. <br />Occ. Load - <br />Fire <br />Zone <br />Use <br />Zone <br />Fire Sprinklers L' <br />Required CI Yes $p No <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 />- <br />SPECIAL USE <br />FIRE DEPT, <br />Page <br />9 <br />