HomeMy WebLinkAboutNo 11108 City Of LakeYil a October 8, 1886
~~jo' 1 1 1 08 CT10N DEPARTMENT
~ ~ 3 ~N A IT Permit Fee 3 9.50_
q \SEWER D W TER PERAA ~
AND RECEIPT stole surcharge
TOTAL FEE'PAID . 40;.
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Permission is Mrdby prantsd to •Teff Shadr k-„{h~T*?Pr
Building on lot. No. 81ock Subdivision W~i_.aha Add i ~n
Parcel ~ 22-83665-030-01 Plat
fn the CITY OF LAKEVILLE to be used as permit to connect to city water and sewer system
This permit is issued on the express condition that the ,ERECTION ~ALTERATtON .,,.REPAIRS
INSTALLMENT ___.MOVING ~DEMOLITtOMrespecfs to the statements certified to in the application for
such permit, and that all work. shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and the State
al` Minnesota ..pertaining to the construction of buildings.
Street Address 9280 Blue Bill B~}y Glenn A. Lanford
Attentipn t1 perlicukty calisdto ttre tatting up pf sheets, making main sewer connections. driveways and Direttpr, Licfnse and Intpeetion
' -Ctfba;Obtain permitfor such cortatruCtion -hom tha CITY Of LAKEVILLE. Inspection Department Not
ResponaY~le Fo' Any Damages to PubRC Unities.
The perms fiOWer understands end egress tttet granting tFis permit is not a warranty or representation by
the City Vfat the project WN be safe or satlsfactory. -
BY -vi- Gt .
The pemtit holder underatahds and agrees that the City shall have the right to make periodic inspection
durlnycpnshuctbn::N.tlte permiR hoklerdoesnot make azrangement for the inspection the Cdy may tum
dt the Water uMr1 such kteiiection'Ytas been made.
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CITY OF LAKEVILLE
,SEWER AND WATER PERMIT APPLICATION
Date ~l/"'~_0 ~ .
Job Site Address J~ ~O ~~cc.,~,c~~
.Legal: Lot ~ Block % Addition
Owner or Builder 5~~~~ ~-~C,(~
Excavating Contractor ~ Tel. ~ ~ l
Address 5.. G - ~`lJ S~~' City e,~-~L~'-'? ° `f~ 6- 7`Y Sl
Private Sewer System ($39.50 + .50) $
Private Sewer Repair ($19.50 + .50) $
•
City Sewer & Water Connections*(39.50 + .50). $
Inside Plumbing-Conversion (19.50 + .50)• $
Sewer Connection Only ($19.50 + .50). $
Water Connection Only ($19..50 + .50). - $
Meter--($60.00) Pressure Reducing Vahze. $
* Metro SAC Charge S/W Connection Units $
TOTAL CHARGES $
Is Street Excavation necessary? Yes
No
Signed
Make checks payable to: City of Lakeville
Send payment to: City of Lakeville Glenn A. .(Barney) Langord
Inspection Dept. Plumbing & Heating Inspect.
Box 957
Lakeville, MN 55044 Tel: (612) 469-4431
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