HomeMy WebLinkAboutNo 10858 +~.e~::~^r. xi°' ~ c ter, ' kf- a',g , .
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City of Lakeville Ju~~ ia, gab
No 1058
INSPECTION DEPARTMENT
Permit Fee 39.50
SEWER AND WATER PERMIT su
AND RECEIPT state sturcf~orge , ,
TOTAL FEf: PA1D . ` 40.00
Permission is (»rttey grctnfisd to Fried~es L.s~ndsCapinq/Piej's;rh ('.nna~~e->r+r+ inn
$uilding on Lot tVo. 11 81ock 1 Subdivision Dodd POinte.'.-e.
~ Pareef ~22~20860-110-01 Plat
in the CITY OF LAKi=1liLLE to be used as yermit to connect to c
't'his permit is issued on the sxpress condition that the -[RECTION ALTERATION .d,.REPAfRS
_rX INSTAI_LMENY -MOVING ^DEMOLITION respects to the statements certified to in the appiieation for
spch permit, and that-all work shalC be done in accordancewi?h the Ordinance of LAKE`?/ILLE, Minncsota and'the.State
~ o! Minnesota pertaining to the construction of buildings.
Strteet -Address 1617.2 Excelsior Drive G1 ~ann,p_T.,,noQrd
'.Attentillhiaper~CUbry CBNeO tO1hB Cutting up of Streets, making main sewer connections driveways and diflCtof, LILYRaf •11d Inspetfto+?
CUtbB: Obfah. permit tot tSUCh COnstruoNOnftom the CITY OF LAKEVILLE. Inspection Department Not
sibN-For Atry Dsrnapea to Pubre Utirties.
-The pandit holder urMe/atands end agreeathat granting this permit is not a warranty or representation by Jf~-t~f~-'--~
the f,~uy Ntat the Wokct wBl be safe or satufacfory. B ~
The pertiNt holder undorstands and agrees that the City shall have the nghi to make periodic inspecton Y
durirtp Catstruoiion. M tlt9 permit Muter does not make arrangement for the inspection the Ciry mey ttxn
on the tgttter iwetesuch ireapectlon has been made.
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' CITY-OF LAREVILLE
,SEWER AND WATER PERMIT APPLICATION
Date ~ ~ .~i d `~1~
Job Site Address ~ ~ ~`~,`1 ~ ~~~~U~
Legal: Lot Block Addition ~C~C"~t.(~`~
Owner or Builder 1 ~ ~
4
Excavating Contractor `del C?C~C>~ C.~1~
f C9
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; Tel . rZ~ ~ ~
Address , ~ ~j-~-VU Cit ~ F
_ y ~-e-4~`? V~-P Zip ~-Q
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). $
Water Connection Only ($19..50 + .50). - $
Meter($60.00) &-Pressure Reducing Val~ze. $
* Metro SAC Charge S/W Connection Units $
TOTAL CHARGES $ , Vv
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 & Seating Inspect.
Box 957
Lakeville, MN 55044 Tel: (612) 469-4431