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A~ovetillier 19 , 8b
4~Cty o Lakeville
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N~ ~ ~ 1 INSPECTION DEPARTMENT 39.so
SEWER AND WATER PERMIT Permit Fie.........
AND RECEIPT statesarclwrge..... so
TOTAL FEE PAID , 40.00
Permiuior, it herby ywnted to Ol-Berg Construction
Building on Lot No. 1D Slock 1 Subdivision Dodd Pofnte 2nd Addition
Parcel 22-20861-100-01 Plat
in the CITY OF LAKEVILLE to be used as permit to connect to city sewer & water system
This permit is issued on the express condition that the _GRECTtON -.ALTERATION REPAIRS
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-INSTALLMENT -.MOVING -DEMOLITION respects to the statements certified to in the application for
such permit, and that all work shall be done in accordance with the Ordinance of LAKEVILLE, Minnesota and the Stste
o/ Minnesota pertaining to the construction of buildings.
I
Street Address 16238 Excelsior Drive (=],ann A 7.?~~rd
Attention is partlcufary caged to the cutting up of streets, making main sewer connections. driveways and Director, L1tMSe iDd Insp~CTlOn
i curbs. Obtain permit for such constructwn }rom the CITY OF LAKEVILLE. Inspector Department Not
Responsible Fa Any Damages to Public Utllines.
The permit holder understands and agrees that grenting this permit ~s not a warranty or representation by '
the City that the project wip be safe or satisfactory. B f '
The permit holder understands and agrees that the City shall have the right to make periodic inspector y ~
during construction. H the permit holder door not make arrangement fa the inspection the City may cum
off the water anti! such inspection has been made.
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CITY OF LAKEVILLE
APPLICATION FOR SEWER AND WATER PERMIT
Site Address : i b ~ ~ ~ 9t ~ ~ ~ ~s ~ v`~`
Legal: Lot j ~ Block ~ Addition ~ v ,r'
Owner o r B uilder : ~ ~ ?
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. t~ €0 , Phone
Address: City: Zip:
Excavating Contractor: ~ ~:.?~.3C ~ ~ Phone: ~;~i,-~ ~ C~I6
Address: : E`z City: /v¢L1..~°% Zip: 1~.~t
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~~
MARE C NECKS PAYABLE AND SEND PAYMENT T0: CITY OF LAKEVILLE
Inspection Department
P.0. Box 957
Lakeville, Minnesota 55044
Glenn A. (Barney) Langord Call 469-4431 to schedule inspections.
Plumbing & Heating Inspector