HomeMy WebLinkAboutNo 11357 { ?
S
City of Lakeville` AP~11 7i is 87
1 ~ 357 INSPECTION DEPARTMENT
SEWER AND WATER PERMIT Permit Fee..........- 3s.5o
AND RECEf PT state surdw?ge .50
TOTAL FEE PAlD , 40'.00
Pbrmission is herbby gronteid to JQhnSOn'EXCavatiri~`
i$uiidinq'on Lot No. ~ 81ock 1 Subdivision Dodd Patlnte
Pareel ~>E22-20$60-070-01 Plat
in the CITY OF LAKEVILLE to be used as pPrutit to connect to city water and sewer s~~ar.,gm
This permit is issued on'the express condition that the -ERECTION -ALTERATION _RfF'Aff2S
'X INSTALLMENT ,_MOViNG -DEMOLITION respects to the statements certified to in the application for
each permit, and that ail work shall' be done in accordance with the Ordinance of LAKEVILLE, Minnesota and the State
of Minnesota pertaining to the construction of buildings.
Street Address- 16115 Excelsior Drive Glenn A. LanQOrd
Attentlon b partit:ulerty Celled to the cutting up Of streets. making main sewer connections driveways and DlrectOr, Litenst and Inspeetloe
CU1bs. Main Permit. (orsui;h construction from dtfl CITY OF LAKEVILLE. lnspectart.Depariment Not
nssporroible ForMy L)mnagea to Pubic UdNtles.
The permM holder understands antl agrees that granting this permit is not a warrardy or representation by
the City that the protect wiM be safe or satisfactory. B y ; ^ f ~ y
r
ThB pemdt hokfer uniieratands&end agrees that the City shall have the right to make periodic inspection
dtxinp Conatructlon..Mlhe permitttoWerdoes not make arrangement to the inspection the City may tam -
off the water untll such Inapectkm ties been made.
i
_T
• ~
4
^
f
7r
O
DATE T ~ - ~
CITY OF LAKEVILLE
APPLICATION FOR SEWER AND WATER PERMIT
Site Address: ~ ~,~L~- l,,r i LC V ~
Legal: Lot Block Addition ~~~-~r,~ ~.r~/~-e-
Owner o r B uilder : !~/w s Phone : ~.s' .7 - ~
Address : X02 ~ ~o ~c~ ~,~~i/ ~ ~ City : C 0 it~c.~.z.cre Zip : .S~S .~'~{y
Excavating Contractor: ~'_(>~l n Solt .r,~c-«-v-e~//.~~ Phone: 41sv~`
Address: ~D~'~'~. (/~~//.e~, ~lv~ City: ~.y-mot. r~v~-~~C.~ Zip ti ~"s 7175
Private Sewer System ($39.50 + .50). $
Private Sewer Repair ($19.50 + .50). $
City Sewer ~ Water Connection ($39.50 + .50). $
Inside Plumbing Conversion ($19.50 + .50). $
Sewer Connection Only ($19.50 + .50).
Water Connection Only ($19.50 + .50). .
Meter (3/4 in} - ($60.00). $
Pressure Reducing Valve ($42.75).
Metro SAC Charge. . $
Sewer & Water Connection Units.
Total Charges ~ ~ ~
Is Street Excavation necessary? Yes
No
MAKE C HECKS PAYABLE AND SEND PAYMENT TO: CITY OF LAKEVILLE
Inspection Department
P.0. Box 957
Lakeville, Minnesota 55044
Glenn A. (Barney) Langord Ca11 469-4431 to schedule inspections.
Plumbing & Heating Inspector