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City of LakevPle Aul~ust 19. ,~$5
N~ 10607 INSPECTION DEPARTMENT
SEWER ANp WATER PERMIT Perini+F.e.......... ~s.so
AND ,RECEIPT' State 5urchorge
TOTAL fEE-PAID . 30.OQ
Permission it hereby grontsd to Jeche Excavating/Stikbilt Contr
Bu;tdinQ on Lot No. 8 Block Subdivision Do~Pointe
Parcel ~~22-20860-080=02 Plat
in the CITY OF I.AKEViLLE to be used as oPrmi i•n Bonn of to r•i t~ wet Pr g,~nrl s>:PUtc~r ex~gtr~m
This permit is issued on the: expresscondition that the .-.ERECTION .__._ALTERATION REPAIRS
~_X. INSTALLMENT .-MOVING. - ,.-..DEMOLITION respects to the statements certified%to in the. application for
such permit, and that all work shall be done in acct+rdancewith the Qrdinance of LAKEVILLE,' Minnesota and he Stste
of Minnesota :pertaining to fhe construction. of buildings.
Street Address; 15138 Excelsior Court Glenn A. LanQOrd
Attentbn is part)culery called M the cutiing'upof streets: making main sewer connections.driveways ~d DinttOr, 1.i:etlll tad lrtspoCtlOQ
C1N68. Obtain permit for such. construction. from the GIN OF'LAKEVILL.E. tnaPeCtbn Department Not
Resporieibte Fvr Arty DameOss toPubfic Utrkbes.
The permit holder understards end agrees that greeting this Permit is not a warranty or reDresentatioa by
theCitythat the project wfil be sateor satisfactory BY
The permit ft01~ understands std agrees that the City ehafi have the right td make periodic inspection
durAtgcot>structbn.IF-lhepermitholder:doeSrwimakearrangementtorthex~apectionthe-Gitymaytum
otf the water unt8 such,inepectfon hae been made.
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CITY OF LAREVILLE
SEWER AND WATER PERMIT APPLICATION
Date ~
Job Site Address ~XCGlCI~~Ji•
Legal : Lot Block ~ Addition ~G d~ ~ h ~c.
Owner or Builder j ~ ( ~ "t'
Excavating Contractor ta'1 ~ ~X G, Tel..~~f y f
Address ~i1J D/c~S'ljof~~dc~- City 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 Valve. $
* Metro SAC Charge S/W Connection Units $
TOTAL CHARGES $ ~ V
Is Street Excavation necessary? Yes
No
~ ~
Signed
Make checks payable to: City of Lakev lle
Send payment to: City of Lakeville Glenn A. (Barney) Langord
Inspection Dept. Plumbing & Heating Inspect.
Box g57
Lakeville, MN 55044 Tel: (612) 469-4431