HomeMy WebLinkAboutNo 10485 . ~
City of Lakeville Aprf? '11,
N~ ~ 04H~ INSPECTION DEPARTMENT 29 so
Permit Fee..........
~E1NER AND WATER PERMIT so
.AND RECEIPT State Surcharge.....
TOTAL FEE PAID ~ ~
P+rrmissioe is hntay ~rontsd to Ka.derlik Masonry / Stikbilt Homes, InC.
$uitding on Lot No. 4 Block 1 Subdivision Dodd Pointe
Parcel gp22-20R6D-04~-Q1 Plat
in the CITY OF LAKEVILLE to be used as permit to connect to city sewer and water systems .
This permit is issued on the express condition that the _ERECTtON -ALTERATION ,-REPAIRS
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!INSTALLMENT ,^MOVING _DEMOUTION respects to the statements certified to in The appiicafioo for
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such pet'rititt.aAd. that all waC~c~~,h,~llji~e~~ dgne, int attar anc,~with the Ordinance of LAKEVILLE, Minnesota and the State
ai' ..iYl.inne¢ota pertaining to .the construiction of buildin° s. `
I ~ Glenn A. La~gord
Street Address lh()71 1;x~`els3~'~r~.ye
C~ Director, lic~ns~snd Inspection
Attentioh Is p~rtlc CalY9d to'the C'WYmg~up o(str6ets: mek)ngi sower sonne~r,~~lr~~eviay's;and
_ orbs. Ohtain,permrt ror such conshuction hom the CITY OF LAKEVILLE. Inspectrort Department Not
6y Rogponslbie FQ~Any~~pame``/}¢¢}s to PubNC U6((lih„„es.4t:,~
The'permH holde~nd~Btannlla and aprbe3~aN'1rarMfr~ thi5'~Wermit'ts not a ~warrarNYOr representation by ~i, _ J
the City that the protect will b safe or satisfactory. I ~'t ~
BY ~~L'b-n-~-
' Tt~`{T(xl$L1holder~arYdeYStends end~a~4ses~that the City shaA have the rir~ltzEq~la~ tumn
dunnfl constructbn. df the permit holder doo§ not make, ardangement for"t1N! ih5pec i N
off the water until suc'tl~inspectbn has been made.
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CITY OF LAKEpILLE
AND WATER PERMIT APPLICATION
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~ ..f,. Date
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Job Site Address _ ~ ~ . ~ h
Legal : Lot Block ~ ~2 Addition ~ ~ ~ ~01,1.1~.7-,~
Owner or Builder ~ T'i i ~ ~ h~o°~ e...s l n n '
Excavating Contractor ~
Address
~~LS' , ~ P ~5 City .YZ9M ~~~~P ZiP
Private Sewer System ($29.50 + .50) $
Private Sewer Repair ($14.50~~+ .50) $
Sewer & Water City Connections*(29.50 + .50). $ ~
Inside Plumbing-Conversion (15.50 + .50)• $
Sewer Connection Only ($14.50 + .50). $
Water Connection Only ($14..50 + .50). - $
Meter-($b0,00) Pressure Reducing Valye. $
* 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 TeI: (612) 469--4431
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