HomeMy WebLinkAboutNo 10765 y
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City of Lakeville siA>~1 1-~-~ t
N~ ~ o~~~ INSPECTION DEPARTMENT
Permit Fee 39150
SEWER AND- WATER PERMIT so
AND RECEIPT state surdusrye
TOTAL fEE PAID . 40. a4
P*rtnlssioe is hairttby prontsd to Wenzel Mechanical/LaCroix Builders
$uilding on Lot No. - -9~ 81ock 1 Subdivision Dodd Pointe 2nd Addition
Psrcet~~22-2061-090-01 Plat
in the CITY OF LAKEVILLE to be used as Permit to connect to city watex and sewer system
This permit is issued on the express condition that the ._CRECTION ALTERATION __._.REPAiRS
..,X_ IN$TAL~MENT -MOVING ____DEMOUTIONrespects 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 State
of Minnesota pertaining to the construction of buildings.
Street Address 1h240 Excelsior Arive Glenn A L.aneord
gtt6retknisp9rtlGA9EFyceNtld to the cutting up of streets, making main sewer connections. driveways end Director, t.ICeRff ifld Inepactiaf
CU'b8. pp{9Y1.pgrmit .fa each constructbn from the CITY OF LAKEVILLE. Inspection Department Not
ti~onslble For/ury+D~ma~es to Public Utilities.
The permit hWder understands end agrees that granting this permit is not a warranty or representation by
the Gtythatdte proJei:tvrabe safe or sa6stactory. By
The permR holder underMmds and agrees that the City shall have the right to make periodic inspectbn
dluNlp Ca1ghLC(idl;lf the permd holder does not make arrangement for the inspection the City may tun
off thavreta trKtl aUCll hapection has been made.
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CITY OF LAKEVILLE
,SEWER AND WATER PERMIT APPLICATION
Date 1E1 Q/.Rb
Job Site Address ,~`1 ~ ~E ~ r' /';'~;s" r
Legal: Lot Black Addition
Owner or Builder LaCroix. Builders, ~ Denny Gelhar
Excavating. Contractor n Tel.
Address 3E=~ ..,ars~.t~' ..,.•-r~~. ~.AC~It~ShN.. 55,122 Zip
Private .Sewer System ($39.50 + .50) $
Private Sewer Repair ($19.50 + .50) $
City Sewer & Water Connections*(39.50 + .50). $ x,,%~
Inside Plumbing"Conversion (19.50 + .50)•-• $
.Sewer Connection Only ($I9.5D + .50). $
Water Connection only ($19.50 + •50). - $
Meter--($60.00) &.-Pressure Reducing Val~re. $
* Metro. SAC Charge S/W Connection Units $
TOTAL CHARGES $
Is Street Excavation necessary? Yes
No
,j
Signed , , ~ f / /
Make checks payable to: City of~Lakeville
Send payment to: City of Lakeville -Glenn A. .(Barney) Langcrd
Inspecti4a Dept. Plumbing & F~eating Inspect.
. Box. 957
Lakeville, MN 55044 Tel: (bl2) 4b9-4431.