HomeMy WebLinkAboutNo 10688 `X,, ,`fit s~!C':`"'hc a +`ti•' tpgg x~;~~ f ;,~k ~rM`,~~"+w ~arsyyG.:~=. .
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City of Lakeville ~aovember 19, ~8s
N~ 1 06 INSPECTION DEPARTMENT
SEWER AND'WATER PERMIT E , PermifFee......... a~.so
` State Surchatrge . , •SO
AND RECEIPT
TOTAL FEE PAID . 30.00
Permistt;on s heretyy 9ronted to Plymouth Plumbing/Joseph rsiller Construction
BuifdinQ on Lot No. 12 81ock 12 Subdivision Donnay's Valley Park 8th Addn
Paircel ~~22-21177-120-12 Piat
in the CITY OF LAKEVILLE to be used as p~1'm'1
t_,_,_o nonnect to city water and sewer sv~tem
This permit is issued on the express condition that the iERECTION -ALTERATION -.,:REPAIRS
INSTALLMENT .-MOVING ~l)EMOLITION respects to the statements certified to in thc,application for
~ such permit, and that atl work shall be done in accordancewith the Ordinance of LAKEVILLE, Minnesota and the State
of Minnesota pertaining to the construction of buiidin~s.
Street Address 102.16 Fair~reen Avenue Glenn. A. Lanford
Attentions parficulary'caNed to the twitting upot streets. making main sewer connectlons, driveways and Direeter, L£MSe and )ntr~ttion
''ourba: Obtain permR'for auchcpnstruction-ftomthe CITY OF LAKEVILLE. Inspectron Department'tVot
Reaponsihte ForAny Damageato Public UdNfiea.
The permR hakler understands and agrees that granting this permit is not a warranty or representation by B
the t~ly tlmt the project wiq t>e safe or satistactdry.
The permit. holder understands and agrees that the Ciry shah have the rrght to make periodic mspectan Y
during cotretruction; H the permit Fwlder does not malcearrangement fa the inspection theCirymey cum
oifthewetettridiauchinapechonhasheenmatle. -
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CITY OF LAKEVILLE
SEWER AND WATER PERMIT APPLICATION
Date y `,,s:~ 8~
Job Site Address f
~i ,~`Gi ~'.~i~- ~`C-~~--f
Legal: Lot Block Add~i~/tion ~
Owner or Builder ~O t' `~e.h 1...0 US"t';
Excavating Contractor ~ D /~l : ~J ~e Tel. -r~~9 -34 T`~
Address ,,,~3 City ~~Jf$, Zip
Private Sewer System ($29.50 + .50) $
Private Sewer Repair ($14.50 + .50) $
City Sewer & Water Connections*(29.50 + .50). $ `~®r0~
Inside Plumbing Conversion (15.50 + .50)• $
Sewer Connection Only ($14.50 + .50). $
Water Connection Only ($14.50 + .50). - $
Meter ($60.00) & Pressure Reducing Valye. $
* Metro SAC Charge S/W Connection Units $
TOTAL CHARGES $ 30 v
Is Street Excavation necessary? Yes
No
Signed LN /b~(X~G~GIr--''
Make checks payable to: City of Lakeville
Send payment to: Citq of Lakeville Glenn A. (Barney) Langord
Inspection Dept. Plumbing ~ Heating Inspect.
Box 957
' Lakeville, MN 55044 Tel: (612) 469-4431