HomeMy WebLinkAboutNo 10977 ,,t.,,, ,~.-`1c~?5~r~,1~h''~'-:~,'`*,`?lyy}.?t, ;.lit... ~r ~~€t{'~.''"7i':.#,t?~'~.'~"fi aalF+w ~~~si -,1tro,1„~J~~~s
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City of Lakeville ~ r, Atlgu$t lz, ~ sb
I ~ ~~~7 INSPECTION DEPARTMENT
Permit Fae.......... 39.50
'SEWER AND WATER PERMiT
AND RECEIPT state surt:horge..... .so
"Ft~TAL FEE PAIfD . X0.04
Pemtituion;i: herby grenfwd to Lakeside ~e!Ner'~6r Water/RSAi HomeB
Building on Lot No. 5 ~ RF~ck Subdidision ,~3o d~Pointe
Parcel 22-20860-OSO-02 Pta!
in the CITY OF LAKEVILLE to be used as ~ermj t to cenne~c~t t~~i rv er?raar rastgr STsEt~~
~ This permit is iuutd on the express condition that the .~ER:ECTION ALTERATION ___._REisAIRS
INSTALLMENT -MOVINGDEMOLITION respeets to the statements certified to in the app{icatian for
such perrvtif, and t1?at alt- work shall be done in accordance with fhe Ordinance of LAKEVILLE, Minnesota and the Sti+~te
of Minnesota pertaining to the construction of buildings.
t Street Address 16122 Excelsior Drive Glann A. Langord
AtteMfon Is perticularty coiled to the cutting up of streets, making main sewer conrtectwns. driveways end DirtCtOr, liiMfA And IRS~iCf10B
cubs. Obtain permit fa such construction from the CITY OF LAKEVILLE. Inspectgn.'.pepartment Not
Responsible For Any Damages to PubNClJti&tles. -
The permit holder undefatatWSand agrees that granting this permit is not a warranty or ret5reaentation by
the city that the protect wiH be sate ar satatactorv: By
i
The pemMt holder uniierstttnd8. end aWees that the City shall havethe right to make periodic inspection
dukq construction. H thA permit. bolder: does: rwt make arrangement for the inspection the City may cum
oft the water until such inspectk7tr Fiaa been made.
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CITY OE LAKEVILLE
,SEWER AND WATER PERMIT APPLICATION
Date ~ , /
Job Site Address ~x~ ~ !_s~, ~
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Legal: Lot Block Addition
Owner or Buildex ~ S . /y~ ~ .
Excavating Contractor ,Si~,~ ~ .~~c~~~' y /_<>x,-f-~r- Tel. ~~y " ~ ~
Address f ,2 G ~ ~ n ~rA--n A--L/' f= City .:.~i4~j/~' Zip?
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Private Sewer System ($39.50 + .50) $
Private Sewer Repair ($19.50 + .50) $
City Sewer & Water Connections*(39.5O + .50). $
Inside Plumbing-Conversion (19.50 + .50)• $
Sewer Connection Only ($19.50 + .50). $ D: v o
Water Connection Only ($19..50 + .50). - $~r~.t~ O
Meter-($bO.00) &-Pressure Reducing Valve. $
* Metro SAC Charge S/W Connection Units $
TOTAL CHARGES $ ~r- C- : G~
Is Street Excavation necessary? Yes
No ,X-
~ Signed ~n~~ ~ ~ ~ ~ ~ ,
Make checks payable to: City of Lakeville
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Se
nd pa ent to: Cit of Lakeville Glenn A. .Barns Lan ord
3'm y ( y) g
Inspection Dept. Plumbing & Heating Inspect.
. Box 957
Lakeville, MN 55044 Tel: (612) 469-4431