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HomeMy WebLinkAboutNo 11099 F ter. rev t+ ns- '+f rte. ,xi, ex, ~ ~_lu„ . ~ z ~~r. :4s a " r~r v, October 3, Sb ~ , 1 City of Lakeville N` ~9~ INSPECTION DEPARTMENT SEWER AND WATER PERMIT Pen»it Fee.......... 39.50 AND RECEIPT sta*e siurcllarge so TOTAL i=EE PAIO , 40.00 P.rmiss;on is henby,yronted to Jeche Excavating/Prestige Developers Buiidin~ on Lot No. ~ Black ~ Subdivision Dodd PoiAte Psreel 22-20860-110-02 Pta trrthe CITY OF LAKEVILLE t© be used as Permit. to 'connect to city sewer & water. system This permit is issut3d on the express condition that the rt'RECTION ALTERATION .._.,_REPAIRS ,X INSTALLMENT MOVING ____DEMOLITION respects to the statements certified to in the application for such permit, and that dll work shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and the Sfate tsf Minnesota `pertairtin~ to the construction of buildings. 16I~!~ Excelsior Ct. Glenn A. Langord Street Address AtMrltion b perticnlerty called to the cutting up of streets, making main sewer connections drweways end Director, Licansa and Inspection C1xb8.. Obtah permit fa Such Constructionhom. the CITY OF LAKEVILLE. Inspection Department Not Reeponaitile For Arty Dernegea to PubNc UtiNties, -.The perm(tholder understands and agreesthat granf3ng this permit is nor a warranty or representation by the f:,ity thffi Me protect wlp be safe or satisfactory. By The pemYtholder understands end agrees that the City shall have the riyht to make periodic inspecton ~ - dwirptwnsb'~ction.:Htltepermithoklerdoes not make arangement for the inspection the Crty may tam off Nfe water until such Inspection he8 tSeen matle: /Y //F" ~ ~ / ~ a ~ 0 O L~ CITY OF LAKEVILLE ,SEWER AND WATER PERMIT APPLICATION Rate " ~ Job Site Address ~~~y./'°-q 7 CX C? c~ c', 1~ ~ / Legal: Lot Block Addition Owner or Builder ~ 1 ,L- f ' r Excavating Contractor ~ ~ ~ X, Tel _ Address ~ } /1 (~J, ~ City c Zip ~ ~ v Private Sewer System ($39.50 + .50) $ Private Sewer Repair ($19.50 + .50) $ City Sewer & Water Connections*(39.50 + .50). $ Inside Plumbing-Conversion (19.50 + .50)• $ Sewer Connection Only ($19.50 + .50). $ ~ C~ Water Connection Only ($19..50 + .50). - $ V~ Meter-($60.00) &-Pressure Reducing Val~re. $ * Metro SAC Charge S/W Connection Units $ TOTAL CHARGES $ Is Street Excavation necessary? Yes No Signed ~ . i Make checks payable to: City of Lakeville Send payment to: City of LakevilleGlenn A. .(Barney) Langord Inspection Dept. Plumbing & Heating Inspect. . Box 957 ~ - Lakeville, MN SSO44 Tel: (612) 469-4431