HomeMy WebLinkAboutNo 11017
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August 28,
City. of Lakeville
~ N°' 1 1 O~ 7 INSPECTION DEPARTMEI~tT
permit Fee....:...., 39«50
SEWER AND WATER PERMIT
AND R EtE 1 PT state swchotrge .
TOTA4 FEE PAfD. 40.00.
Petvti?iuion is hereby erontad to Larson ExcaVatin~/Ratzlaff Constr.
Building on Lot No. 9_ 81ock .._.2_ subdiviron 22-20860-090-02 Dodd Pointe
Pareei 22-20860-090-02 Plat
in the CITY OF LAKEVILLE to be used as Pertn3.t to connect to cites sewer and water system
This permit is issued on the express contfition fhat the -ERECTION ~ALTERATtON ..REPAIRS
_X INSTALLMENT,MOVING ^.bEMOLITIONrespects- to the. statements certified to in this application fore:.
such permit, and that: all work. shat! be done in atcordancewith the Ordinance of LAKEVILLE, Minnesota and he s#att;
of Minnesota pertaining to the construction` of buiidinys.
Street Address 16140 Excelsior Ct. Glenn A. Lan~ord
sets, making main sewer connections, driveways and: DirletOr, Lissnse arld 1?tspetNon
Attention is partlcularycaNsd t0 the IXdUng up of sh
curbs. Obtain pBrntR for suchconstruclron hom the CITY OF LAKEVILLE. InspeCtron Department Not
ReaponaibieForAny:DamagestoPtrW'icUMitiea.
The permit holder tuttlerstands and agrees that gr~tingthis permit is not a warranty or representatkn by ~
the City that the prokctwHl be safe. or satisfactory. _ BY
The pennkholder understands and sprees-that the CRyahaq haae~4he nyhCto rnalca periodic inspection- ~ ~ -
durktgconelruction::H the perms hoW~.doesnotmakearrangement for the nspectionlheCtry may ttm'
ott the weta? tatNl auoh inspection tree kl made.
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CITY-OF LAKEVILLE
,SEWER AND WATER PERMIT APPLICATION
Date `~~.t? (c~ .
Job Site Address / ~.Cl
Legal: Lot Block Addition
Owner or Builder y'' ; .
Excavating Contractor ~ ,'tom-~C:~~ ~-a. ~ Tel. ~ ~~a~~
Y ~
Address 1 t~P'r" L% I''~i.~~.~ City ,1c:. ~ r~.Z~.,=..~ Zip
Private Sewer System ($39.50 + .50) $
Private Sewer Repair ($19.50 + .50) $
City Sewer & Water Connections*(39.50 + .50). $ C%~?'
Inside Plumbing-Conversion (19.50 + .50)• $
Sewer Connection Only ($19.50 + .50). $
Water Connection Only ($19..50 + .50). - $
Meter-($60.00) &-Pressure Reducing Vahre. $
* Metro SAC Charge S/W Connection Units $
TOTAL CHARGES $
Is Street Excavation necessary? Yes
No
Signed ~ ~c-~-~'~ i~,t`~.-t,~L~~.~ .
Make checks payable to: City of Lakeville
Send payment to: City of Lakeville Glenn A. .jBarney) Langord
Inspection Dept. Plumbing & Heating Inspect. .
Box 957
Lakeville, MN 55044 Tel: (612) 469-4431