HomeMy WebLinkAboutNo 10600 ;trek ~ ;~,.~!~~`,,n:fi,{'.Yxx:r3~k ~x rt, 'r f _ -
City ,of Lakevi I le arr~us,~ ~2 • ~s.~5
N® ~ ~60~1 INSPECTION DEPARTMENT
Pisetifi F.a.........: 2~
SEWER AND WATER PERMIT' ~
AND RECEIPT ste>tes~f~f+~r~.....
TOTAL FEE PAID , .30.00
Pinv?issioa is h®r~by grontad to P1 n~,t-h At.,,,ohi T ~~~~ef: ~eft9E~
Buitdiny on Lot No. 11 81ock Subdivision l~nnnavr>~ V~lla~ Park ArS, dddn.
Paru1~22-21177-IL0-I2 Pfaf
in the CITY OF iJ1KEVILLE to be usetl as permit to connect to' ~i ~ e~^rF+r And ep~r sa3xst~f`a
This permit is issued on he express condition'Yhat the -~ERECTlON ~ALTERATfON ,.wREPAtRS
~`tNSTALLMENT .rMOVING ,,.-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 ~AKEYl1.LE,: Minnesota and iM Stab
~ of Minnesota pertaining to the construction of bi?ffdings.
Street Address 16198 FairgTeen An nuP
Attehtktn ie paracularty called ~ the cutting up of streets. making maM sewer connections. driveways entl DirtetOr, LitMi! a ' IttsOoEtiOn
curbs. Obtalr permit for each ~conalruction hom the CITY OF LAKEVILLE Inspectan F)epartment Not
Respotgide:For Any DamegestoPubtc UtiNnes. ~
;
The permHholdar understands end agrees that grentmghis permdis not a warranty or representation by
the(gty:tf~:theproiectwipbeeaieorsatisfaetory B ~ i ;
The permit holder understands ~d agrees that the City ahaM heve:the right to make periodic inspection. y
durintg cotteVUCtion. M tlta permit holder does not make ~rangement for the inspection the Ciy may tam
off the wade? unt8 such IrrspecTbn Figs been made.
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CITY OF LAREt1ILLE
SEWER AND WATER PERMIT APPLICATION
Date ~ ~S
Job Site Address f ~0~~1' G-~z.e/?
Legal: Lot Block Addition
Owner or Builder JIG /'~'l~t'f"'-
Excavating Contractor ~ ~ Tel .y~6~ g4 3~ 73
Address /~},2~` ,Z~ /ylvc City ~ly tr.~ Zip ~S ~/y~
Private Sewer, System ($29.50 + .50) $
Private Sewer Repair ($14.50 + .50) $
City Sewer & Water Connections*(29.50 + .50). $ 3p,d p
Inside Plumbing Conversion (15.50 + .50)• $
Sewer Connection Only ($14.50 + .50). $
Wa~.er Connection Only ($14.50 + .50). - $
Meter ($60.00) & Pressure Reducing Val~ze. $
* Metro SAC Charge S/W Connection Units $
TOTAL CHARGES $ ~O
Is Street Excavation necessary? Yes
No
Signed tji~~;,~ J ~J
Make checks payable to: City of ~akeville
Send payment to: City of Lakeville Glenn A. (Barney) Langord
Inspection Dept. Plumbing & Heating Inspect.
Box 957
Lakeville, MN 55044 Tel: (612) 469-4431
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