HomeMy WebLinkAboutNo 10761 ~~~`y dr.V~3'Y~~v~'~n e,N~~~~ 9 .r .dro ~*,+,~rnffirY~ T ~i - 'QG-1'1 K r
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City_o.~°:Lek-ev'rll~ April lo. ~6
~'0 14761
INSPECTION DEPARTMENT
Permit Fee.......... 39.50
SEWER AND WATER PERMIT so
AND RECEIPT state sarcherge .
TOTAL FEE PAID . 4.0.00
P~rmittisien ie herby gronrd to Hiltner Plumbi,nQ/Jos. Miller Construction /
Building: on Lot No. 1~ 81ock 10 subdivision Donnay' S -Val1~V Park 8th Addn
Psrcei 422-21177-180-10 Piat /
in the CITY OF LAKEVILLE to be used as arm t to connect to cit water and -sewer s stem
This permit is issued on the express condition that the ~ _ERECTION °ALTE~ION -REPAIRS
i
_ INSTALLMENT ._M4VtNG _DEMOLI'TiON respects- to the staternent3 c~~Ff~'Ified to in the appliwtian for
1 t
wth permit, and that all work shall be done in accordan~ewl(hi~e~rdinance o[ti~+,Src.VILLE, Minnesota and the State
of Minnesota pertaining to the construction of buildings.
Glenn A. Lan ord
e
16289 Fantasia Avenu g
Street Address
AtNnMat b pargoukrly osNBd to the cutting up of sheets, making main sewer connecNoru. driveways and DirettOr, LIL~nte atnd Inaatfion
CIRb6. ObtaY1 perm! for such construction from the CITY OF LAKEVILLE. Inspeclkxi Department Not
For Any 3antagea to PubNc U tiGties.
The pemtit holder understands end agrees that granting this permit is not a warranty or representation by
iheCftyth9ttheproieCtwilbesefeorsatisfactory. }3y i ~ ~ T' rj
The PermR.holder understands and agrees that the City shall have,.the right to make periodic inspectbn ..~~~--.JJi~~~~
during f~BhYlCtlo(1. H.the permft holder does not make arrangement to7`tlre ~spection the City may tum
ott the watertrHil such krepectbn has been made.
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CITY OF LAKEVILLE
,SEWER AND WATER PERMIT APPLICATION
D e ~ r
at
Job Site Address ~T
Legal: Lot Block ~ Addition
Owner or Builder v.a r l,2 p~ -
Excavating Contractor r~ r' !'"I , Tel.~~'~~~~
Address ~~ry~~~~ ~lrS.~C' City ~z•~ ~yurv~~ Zip
Private Sewer System ($39.50 + .50) $
Private Sewer Repair ($19.50 + .50) $
City Sewer & Water Connections~(39.50 + .50). $
Inside Plumbing-Conversion (19.50 + .50)• $
Sewer Connection Only ($19.50 + .50). $
Water Connection Only ($19..50 + .50). $
Meter-($60.00) &-Pressure Reducing Valve. $
* Metro SAC Charge S/W Connection 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. -(Barney) Langord
Inspection Dept. Plumbing & Heating Inspect.
Box 957
Lakeville, MN 55044 Tel: (612) 4b9-4431
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