HomeMy WebLinkAboutNo 10493 ~1.
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City o~ take ` ~ s
1 Q4s3 INSPECTION DEP1fiRTM-ENT ~ 29.5
M Permit Fee .
SEWER~?I~D WATER PER
q _ . so
AND RAC E i PT ~ State Sureho?g .
I TOTAL FED t0 30.OQ
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Larson excavating / ~ol~?en F.a~le Builders
Parmission is hereby granted to
pi ,
Building on Lot No. Block 1 Subdivi
Rarcel ~1~2.2-2~3f3fi(1-X2.0-O1 Plat r ~ .
in the CITY OF LAKEVILLE to be used as P~gr>tl} t t o c o ~ c t t o c it sewer
.This permit is issued on the express condition that the ._ERE`CTION ALT6~ATION" -REPAIRS
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INSTALLMENT -.MOVING DEMOLITION respects to~}h~ stateme~fs-Certified to in the application for
suth permit, and that all work shall=be done in accordance with the Ordinal~e of LAKEVILLE, Minnesota and the State
of Minnesota pertaining to the construction of buildings.
1639 Exce~.sor Drive p^^ A Iang~rrl
Street Address
Director, license and Inspection
AtteMbnb pertlCUlerly taped td the outiing uR of Streets. making main sewer connections driveways end
' ourbsr Obteln permit fq' 8uoh conHttvction-from the CITY OF LAKEVILLE. Inspection Department Not
Respataible ForAtty Damageato PubYaU6lities. ~
The permMholder understand8 ~d agrees that granting this permit is not a warrarrty or representation by yr i
the citythat the RlOjBOt Mr~beBHfe a89l18factory. By
The petmR hoidda[.tpldBrBtandB and agfees that the City shall have the right to make periodic inspection
dUrMq e~netruction: H the permd hok/er does not make arrangement to the inspection the City may Cum
dff the water untfl8uch inapectidn has been made.
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CITY OF LAKEVILLE
SEWER AND WATER PERMIT APPLICATION
Date ~ -
Job Site Address ~
Legal: Lot Block Addition
Owner or Builder
Excavating Contractor Tel.
Address City Zip
Private Sewer System ($29.50 + .50) $
Private Sewer Repair ($14.50 + .50) $
City Sewer & Water Connections~(29.50 + .50). $ !S~
Inside Plumbing Conversion (15.50 + .50)- $
Sewer Connection Only ($14.50 + .50). $
Water Connection Only ($14.50 + .50). - $
Meter ($60.00) & Pressure Reducing Val~ze. $
* 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: Citq of Lakeville Glenn A. (Barney) Langord
Inspection Dept. Plumbing & Heating Inspect.
Box 957
Lakeville, MN 55044 Tel: (612) 469-4431