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City of I_alceville April 23, ~ a7
~ ~ 389 INSPECTION DEPARTMENT
Permit Fee ; . 39.50
SEINER AND WATER PERMIT ,
ge...
AND RECEIPT state surchor
TOTAL FEE PAID . ~ 40.00
P~rmisition is heraby prontsd to Jeche ExC1V8tirig
Building on Lot No. 6 Block 1 Subdiviron Dodd Pointe Ord Addn
Psrcei ~~22-20862-060-01 Plat
in the CITY OF LAKEVILLE to be used as PERMIT TO CONNECT TO CITY WATER AND SEWER SYSTEM
This permit is issued on the exp~s~co~nditioq .that the ,ERECTION ,ALTERATION .-..REPAIRS
-.X FNSTALLMENT -MOVING ^DEMOLITION respects to the statements certified to in the appticafion for
uth ptsrmit, and that all work shall be done in accordance with the Ordinance of LAKEVIL~E, Minnesota and the State
a$ Minnesota pertaining to the construction of buildings.
Sheet Address. 16070 Excel Way ~ Glenn A. Langord
Attention'b peAteulery ceNed to the cutting up of streets. making main sewelt con~ecllons, driveways and DirfctOr, License end Ihlirletrlen
cubs: Obtain perntit fa such constructwn from the CITY OF LAKEVILLE Inspection Department Not
Responaitib ForAryr Detnages to Public UtiNUes.
The permit hOkler urlderetands antl agrees that granting this permit is not a warranty or representation uy 'r""7v" - 1
the City thaffi the project WIN t>e safe or satisfactory. B
The permit holder understands and agrees that the C+ty shall have the right to make periodic inspector Y _
during construction...rche permit holder dues not make arrangement to the inspection the City may cum ~ ~
off the water until such Inapecton has been made.
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CITY OF LAKEVILLE
APPLICATION FOR SEWER AND WATER PERMIT
Site Address:/~ ~ ~~',r
Legal : Lot ~ Block Addition n ~r _ ~ ,
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Owner o r B uilder : ~ C+ ~ Phone.:
Address: City: - a ~ Zip:
Excavatin Contractor. p J- t~
g ~ `se,L~. C~"'L ~ L.-~ Phone :~~5 ~ v~~
Address: ~ ~ ~ .O ~ .City: Zipt ~ L~
• .Private Sewer System ($39.50 + .50). . $
Private Sewer Repair ($19.50 + .50). $
City Sewer & Water Connection ($39.50 + .50). $ ~~E O
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 LTnits.
Total Charges ...................$----~E-~c.~•(~-`~
Is Street Excavation necessary? Yes
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MAKE C HECKS PAYABLE AND SEND PAYMENT T0: CITY OF LAKEVILLE
Inspection Department
P.O. Sox 957
Lakeville, Minnesota 55044
Glenn A. (Barney) Langord Call 469-4431 to schedule inspections.
Plumbing & Heating Inspector