Permits - Permit# 55 - 2478 Black Lake Road - 1/1/1968No. Z5d—Application for 13uHding Permit
APPLICATION FOR BUILDING PERMIT
2i0 the.......... if. .!-.1.4...
..l....
of the..............11.. [.....G.1.b..}...............................of,......... !..!? ....../.... .1..........................................in the County of
1
........ Pj wo. Q d.. v ................... State of Minnesota:
The undersigned owner whose address is......... .......... .....................................
......................................:...................................................................................................hereby applies for a permit ...........
.............................................................................................................................................................................................................................................................
(Build, install, add to, alter, repair, move, wreck, as case may be)
a building described as follows: kind of construction..........!j1..0.......................................................................................
........................................................... :..............................................................................................................................................................................................
;
front or width in feet ............oi .Q...............; side or length in feet...............! ...........; height in feet........... ....................;
D i
No. of stories .................................; contents in cubic and square feet
.:....6d�`6...1�.,..?,.:....................::D....G:l/.
upon that certain tract of land described as follows: Lot ........ .......... .............................. ; Block ................................................
plator addition .................................................................. ... ..Q.................1..... f.. ...4..................................................................................;
which is of the following size and area; width...................................................feet; length ................................................... feet;
area...............................................................................................................................................................................................................................................
and said building to be known as No.... 2.6A
...... Street...... &/a.:e...k..... L'X-At..... D.1:8�.........................
in said. ....... ................................................................. ...... ; and hereby agrees that, in case such permit is granted, that
all work which shall be done and all materials which shall be used shall -comply with
/the plans and
specifications therefor herewith submitted and with all the ordinances of said ......... &//.................................
applicable thereto.
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DET.41LS .4ND RE,M.4RKS
ZV/q re Vol
..................
�ej � - Owner
i1p
40
ft �
Otnte ofMinnesota*
County of ... L..Y.e..n..r�..s...i..�2.......................
l 1..1.G.��...�.....of.... ....... .oXI.........
...................................... ..................... ....................................
APPLIC.4TION
OF
V
U`' �...�1 Y...............a. r.J' '�
:t... �.. .....13... �,� ......x./.� ,If
FOR BUILDING PERMIT