HomeMy WebLinkAboutNo 11348 ~.`n .s
City of Lakeville April 1, ~ 87
NO ~ ~ 348 INSPECTION DEPARTMENT
Pernoit flee ' 3 9.5 0
SEWER AND WATER PERMIT
AND RECEIPT store sKCtiarge .so
TOTAL FEE Pati9. 40.00
Lakeville Plumbing & Htg./Roxberg Homes
Pemnission is hereby 9ronted to
Building on Lot'Ne. 2 Block 2 Subdivision Dodd Pointe 3rd Addition
Psreel 22-20862-020-02 Flat
in'the CITY OF LAKEVILLE to be-used as Permit to connect to city sewer water system
fihis permit is issued ot~ the express condition that. the _:GRECTION _ALTER~TION , ._.REPAtRS-
___X INSTALLMENT .MOVING ^_DEMOLITION respects to the statements certified to in the apptieatian fol°
sorb permit, and that all work shall be done in accordance with the Ordinance of LAKEVlLLE, Minnesota and- tM Stattr
of Minnesota prrtainin9 to the construction of buitdinys.
16085 Excel Way Glenn A. Langord
Street Address
Attention is particulary ceNsd topre cutbnp up of streets, making main sewer connectlprts, driveways and Qireetor, Lisenre snA InupeGtlon
curbs. Obtain permilfor such conetructbn:tranthe CITY OF I.AKEVILLE. InePectan DepartmentfJot
ResponspMe For Arty Damages to PuDI~ Utilities.
The permit holder understands and agrees that granting this Rerma is not a warranty or representation by )
the lipy prat the Molest wte be safe or satisfactory. $Y
The pemdt holder understands end agrees that the City shall have the right to make periods inspectbn-
during cortalructbn:h ttre demtit twld~ does not make arrangement for the inepechon the City may rum-
off the water unity such Jnapection hea beenmade.
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CITY OF LAKEVILLE
SEWER AND WATER PERMIT APPLICATION
Date
t~ f
Job Site Address t/ d~,
Legal: Lot Block Addition ,~!.~Q' ,~"p~
Owner or Builder ~ ~ ~ L~~`
Excavating Contractor ~ ~ ~ r ~ ~ ~ Tel.
Address tJ,~~ ~,~C.,~~ Cit9 ~P 1~ 1~L°{ Zip
Private Sewer System ($29.50 + .50) $
Private Sewer Repair ($14.50 + .50) $
City Sewer & Water Connections*(29.50 + .50). $
Inside Plumbing Conversion (15.50 + .50)• $
Sewer Connection Only ($14.50 + .50). $
Water Connection Only ($14.50 + .50). - $
Meter ($60.00) & Pressure Reducing Val~re. $
* 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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