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HomeMy WebLinkAboutNo 10970 r. , •;u "~;4 -..w . _ . ~ •Wa r, e.- ~ r=l~.'1 ~`-~r~,Y ~y.FAr Pitt ~ ~ ~SE[~ER AND WATER CAN NAT BE 1?OOI~ED UP UNTIL APPROVED BY THE CITY ~~ATER DEPARTMENT City of Lakeville Aueust is 86 N°` ~ a~70 INSPECTION DEPARTMENT SEWER AND WATER PERMIT P'~""~F°`.....~...._ 39.50_ 'AND R E~ E I PT sure surcharge so TOTAL FEE PAI®. 40.00 Pemnission is herby gran»d to ~ Hiltner ,Blumbing/Jos '°iillg~Constr Building on Lot Na. Blotk _l~ Subdivision Donnavt s Valley Park 8th Pareei #22-21177-101-12 Ptat in the CITY OF I.,AKEVILCE to be-used as ,~ermt t to connect' to city water and sewer syg.i-em This permit is issued on' he express condition`that theERECTION yAL?ERATiON - ---.REPAIRS INSTALLMENT -.MOVING.:.. ~QEMOLITIONrespeds to the statements certified to in the apptitaHon for such permit, and that alt work shall be done. in accordancewith the Ordinance of LAKEYtLLE, Minnesota and the State of Minnesota pertaining to the construction of buildings. Street Address 16018 Fairereen Avenue Glenn A. 'Lans?ord Attention is pertlculery celled to the cutting upof streets,.makingmainSewer conneccGOna, drrvewaYs and - t)irtttOr, Lis~nte Ind /nsplcNOn curbs. Obtain permit for auchoonstructionfranthe CITY OF LAKEVII.I.E: Inapectbnt)epartment Not RespanefbleFaAnyl>amegestoPubficUOlities. t The permit holder understands and. agrees that granting this permd is noteawarrarMy or representation by the Gry that the protect wM Ile safe or satisfactory By The pemM hOlderuhderstmtds and agreesthet the City shall haue•the rpht to make periodic inspectbrt during construction: M the permit hokferdoes rat melee arrangement for ttre u~apecbon the Gty may tum. on the water untll such inspection has been made. S 1r / r I ~ ~ ` ~ / ~ ~ O CITY OF LAKEVILLE .SEWER AND WATER PERMIT APPLICATION Date Job Site Address ~f(~ ~ ,~f-~~! Legal: Lot Block Addition Owner or .Builder ` ' Excavating Contractor , - Tel. Q ~C~ Address City Zip Private Sewer System ($39.50 + .50) $ Private Sewer Repair ($19.50 .50) $ City Sewer & Water Connections*(39.50 + .50). $ ~ DCJ~ Inside Plumbing-Conversion (19.50 + .50)• $ .Sewer Connection Only ($19.50 + .50). $ Water Connection Only ($19..5 0+ .50). $ Meter--($60.00) Pressure Reducing Valye. $ * Metro SAC Charge S/W C©nnection Units $ TOTAL CHARGES $ Is Street Excavation necessary? Yes No Signed Make checks payable to: .City of Lakeville Send payment to: City of Lakeville Glenn A. _(Bameq) Langord Inspection Dept. Plumbing & Heating Inspect. Box 957 Lakevi 11e, MN 55044 Tel: (612) 469-4431 ~ _