HomeMy WebLinkAboutNo 10606
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City of Lakeville a„g,,Rr ~ 9, i~
~ QsO~ INSPECTCON DEPARTMENT
SEWER AND' WATER PERMIT' Permit Fes..... 0 29.50
State Surcfoarge .50
AND`RECEIPT -
TOTAL FEE PAID ~ 30.00
Permission 'is haroby granted to,~jprh Fx~avatin~4r. i~h-L.l,t ('nn~rr
Building on Lot No. 13 ' Block Subdivison Dodd Pointe _
Parcel X22-24$60-I34-01 Piat
in th@ CITY OF LAKEVILLE to be used as ~ AY'mi t to r•nrrnPrt to r•i t-y tratcr a.,ri co -+nr ova+o+r
This permit is issued on the express conditle~rt'that the ..-ERECTION ."ALTERATI,QN REPAIRS
i' X INSTALLM NT _ ~AOVI~IG , ' ~ EfMIG~iTtQN respects. to the fatements certified to in the application for
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,-such .per~~itthat at~~irp~~~t.,~e in~cci~tianc~w h the Ordinance of LAKEVILLE, Milnttesota and the Stah
of Minnesota perfiaininp to the construction oi'by~,di
f~ t
Street Address FxCg1 S; nr Tlri~ra near s T °++aord
At[entlon a particulary called to the cutfittgup of streets, making main sewer connections; driveways and DirlitOr, Litenf~ and Inaptction
curbs. Obtain permit far suCh.COnsNuCtIO(tfrom theGiTY OF LAKEVILLE. Inspection Department Not -
Responsible Far Any Damageato.Pubnc UtiAttes.
The permk holder understands and agrees that granting this permit is hoe a warranty ar representation by g
ttte sty that the project wln besets or satistactary ' '
$y
The permn FtoWer understands and agrees that the Gity ahadhave the right to make penorfic inspection
during construction. H the permit holder dons not retake arrangement for the inspection the City'may tum
ott the water until such inspection has been made.
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CITY OF LAKEVILLE
SEWER AND WATER PERMIT APPLICATION
Date ~ ~ ~ / - ~,S
1 _
Job Site Address ~x ~,e. ~-_~'ah ~~C.l~-P_
Legal: Lot Block Addition ~~Q ~ j,~
Owner or Builder ~~'i~'~ ~ ~t
Excavating Contractor .L ~j( C._ Tel . ~ t ~ L ~''S
Address ~ ~"it>~ ~ ~ ~ ~ i) r~ ~C, r- ~ City ~ a ! ZiP .~s~~~i~
Private Sewer System ($29.50 + .50) $
Private Sewer Repair ($14.50 + .50) $
City Sewer & Water Connections*(29.50 + .50). $ Q,U v
Inside Plumbing Conversion (15.50 + .SO)• $
Sewer Connection Only ($14.50 + .50). $
Water Connection Only ($14.50 + .50). - • $
Meter ($60.00) & Pressure Reducing Val~re. $
* Metro SAC Charge S/W Connection Units $
TOTAL CHARGES $ _,~D
Is Street Excavation necessary? Yes
No I/
z ~
' Signed L
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
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