HomeMy WebLinkAboutNo 11353 . .
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City of Lakeville - April 3, `g~
N~ ~ ~ 3~3 INSPECTION DEPARTMENT X9.50
Permit Fee
.SEWER AIVD WATER PERMIT so
AND RECEIPT State Surthorge .
40.00
TOTAL FEE PAID .
Prrmission is hereby yrontod to R•' C. Phwibin~/Sons Constr.
BuiWirw on Lot No. 11 _ 81ock 2 Subdivision Dodd Pointe 3rd Addition
Patyeel 22-20$62-110-02 Plat
in this CITY OF LAKEViLLE to be lased as Fermit to connect i;o city sewer & water system
This permit is issued on the express condition-'that theERECTION ~._.At.TERATION REPAIRS
~Y INSTALLMENT -.MOVING ~DEMflLITiONrespects to the statements certified fo in the application for
twch pern?it, and that ail work shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and the State
of Minnesota pertaining to the construction of buildings.
Street Address 16005 Excel Way Glenn A. Langord
Attentkm a partlculary celled tothe cutting upof streets, mahmg mainsewer connectiwis, driveways end 1Qirector, LisMef and Insyectlon
cabs. Obtain pem+k for each cor>Btruction from the CITY OF IAKEVILLE Inspecton pepartmenE Pbt
ResponslblePorArryDamegeatoPuDAcUtifiUes. ~
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The permH holder understands 8nd agrees that granting this permit is not a warranty or representation by
the City tl11it the protest webs sate or satisfactory. B
Y
The pe+mlt tgld~ understands and egreesihffi the City sha8 have~the right to make periodic inspection -
durktg conetructian. fi Me pertnft hdlder does nct make arrangerrant for tFie inspechon the.City may tam
off the water untll such 4tepectlonl~ been made:
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DATE , ~
.CITY OF LAKEVILLE
APPLICATION FOR SEWER AND WATER PERMIT
Site Address: ~
i Legal: Lot Block ~ Addition ~r-~C,4~4'
Owner o r B uilder : ~ Phone : ~ - ~
Address : ~ ~Q ~l..a-G~ City : Zip : ~~s`/ o '
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Excavating Contractor : Phone : / ~ l~
Address: City: 9L~-i~a~~~ Zips c~::
~ s5
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Private Sewer System ($39.50 + .50). $
Private Sewer Repair ($19.50 + .50). $
City Sewer & Water Connection ($39.50 + .50). $ ~
Inside Plumbing Conversion ($19.50 + .50). $
Sewer Connection Only ($19.50 + .50).
Water Connection Only ($19.50 + .50).
Meter (3/4 in) - ($60.00). . . $
Pressure Reducing Valve ($42.75).
Metro SAC Charge. . $
Sewer & Water Connection Units.
Total. Charges
Is Street Excavation necessary? Yes
No
i
MARE C HECKS PAYABLE. AND SEND PAYMENT TO: CITY OF LAKEVILLE
Inspection Department
P.O. Box 957
Lakeville, Minnesota 55044
Glenn. A. (Barney) Langord Call 469-4431 to schedule inspections.
Plumbing & Heating Inspector