HomeMy WebLinkAboutNo 10752 '~FCnt'N „ `~-r~~' .y k -"Y k~ 'i ~~'.i tl „ ~ ~ z'r. " , ~1 ~~'::~.3. f' in::"'~"', i'Q`y'',
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City of'~akeviile -=®~zil 7.
N~ ~ INSPECTION DEPARTMENT
SEWER AN~~l~WATEF~ RERlIAIT ~""t~""'••-••~"""~g_50 i
AND RECEIPT s*~e srdwrge
TOTAaL fixE f'AtD .~,(3.Od
Perrnission is hereby granted to OZ-13eTtx CQt18tXUCt~.OA
Buitdinfg ot? i.ot No. ~ ~ Blotk Subdivision Bodo P01n~e~ 2nd Add~.tiori
Parcet X22-20861-110-01 Plai
in the CITY OF IJIKEVILLE to be used as pe•Cmit to cmnn®ct to cite rtar and sewer ~v>4r~>~u
This pe?mit is issued on the express condition that the .rERECT'tON ^ALTERATION .~..,_REPAIRS
X INSTALLMENT _MOVING DEMOLITION respects io the statements certified to in the application for
such permit, and that all work shall be done in accardancewith the Ordinance of LAKEVtLLE, Minneesota and the Swats
of Minnesota pertaining to the construction of buildings.
Street Address 1~ 36 x o1 ai o bri ve ~'tl ern A L~ngortl
Attentbn fa peAfculary called to the cutting up of sheets, making main sewer connections. driveways and Dintler, license and inaaettton
curbs. ObtBln permit for each conaNUCtkm hom the GTY OF LAKEVILLE. Inspection Department Not
neeponaible For Arty Damages to Public U BNties.
The permit hOldBr understands and agrees that granting this permit is not a warranty or representation by
the Gq Metthe project wdl be safe or satisfactory. B r
The p8ftnit holtlar understands and agrees that the City shall have the right to make periodic inspectan Y
during canBM'tlCtion• H the permit holder does not make arrangement for the inspection the City may cum
f off the water ure~l such inepectbn has been made.
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CITY OF LAKEVILLE
,SEWER AND WATER PERMIT APPLICATION
~ Date ~ ~ ~ ' O
Job Site Address ~ ~ ~ ~as1~ ~~_~.t ,r~~
Legal: Lot Block ~ Addition .DD.10~ `p ~~~7 ~ ~~,Q,~ ~d
d
Owner or Builder (~L~~,~~, G~~~~"o
Excavating Contractor 2g~~ ~ ~~~~a Tel.
Address ~ I S~ ~`f~ City ~~y~1..~ ~~~y Zip 5~~~,~
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-($b0.00) & -Pressure Reducing Value . $ ~ ~
* Metro SAC Charge S/W Connection Units $
W
TOTAL CHARGES $ ~ 6 ~
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 Tel: (612) 469-4431