Permits - Permit# 109 - 2486 Black Lake Road - 1/1/1970No. 258—Application for Building Permit.
Miller -Davis Co.. Minneapolis
APPLICATION FOR BUILDING PERMIT
Zo The ...........................:... f. ..rs.r ..........................
........:..........................0.............................. :..................................................................................
of the ................ /.....1 ..:... $.......................... of . ............. ......
&'A................................in the County of
........ ......te..Y.. $1-.Ir.�.I..'o ................I State of .Minnesota:
The undersigned owner whose address is.........................�....................
..........................................................................................................................................hereby applies for a permit to ..........................................
g:.%........................................................................................................................................
(Build, install, add to, alter, repair, move, wreck, as can may be)
a building described as follows: kind of construction .....................fig, 1A.&.4.4.................................................................
...........................................................................................................................................................................................................................................................;
front or width in feet ................. 1........... ; side or length in feet ............ rP.................; height fee
t .......... ....................
No. of stories........... /.....................; contents in cubic and square feet ...................................................................................................... .......................................................................
upon that certain tract of land described as follows: Lot ... ... .......................................... ; Block ................................................
plat or addition ............ ,r .. ..... ...1�...U....r.....................%...G..r..... ,.�........ ..5.....' O ,
which is of the following size and area; width ................................................... feet; length ................................................... feet;
area.............................................................................................................................................................................................................................................`....
and said building to be known as No.. ................................. Street.......... Z. ........:x......
/[�1.. .
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.
DET.41LS .4ND RE,M.RRKS
...................................................... ..............
Owner
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