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No 10633
~.:.z a ! k. City of Lakeville ~ September 30, ,~s~ N~` ~ ~INSPECTI®N DEPARTMENT SEI+VER-AND 1AiATER ~*ERM1l` .~e"`~~~,.....::.. -State Swcitarge AiVD RECEIPT T07AL FEE PAID. ~©+0~ Piermission is hereby granted to P~vatnttt`h P7 t'"'htng/Glenn Grob i :Building on tat No. 17 Biock 11 Subdivision Donnay's Va11ey Park 8th Addn Parcal X22-21177-1:70-11 Plat: _ in the CITY bF LAKEVILLE to be used as Hermit to connect to Ciiw~ w er and ,ewer tsvsst'em This permit is issue<J on the express condition that the .ERECTION _.._,ALTEIYATtON _,.,..,ftEPAfRS ..~X' INSTALLMENT .-..MOVING ____DEMOLITION respects to the st~iterhents certified to in the appGeation far such permit, and that ail work shalt be done in accordance with the Ordinant'~d~1~~~Li.`E, Minnesota and the Stsh I of Minnesota pertaining to the construction of buildings. ~ ~ ~ ? Streat Address 16326 Pante.sia Avenue Glenn A. Lan~rd Attention s particulary cellad to'the cut!(ng up tN"streets, making main sewer connections, driveways and DireetBr, LitlRtit led tnspettita•n Curbe: Obtain permit for aueht:onetructionfrorn the CRY OF LAKEVILLE. Inspection Department Not - ;.FtesponsibleFOrAnyDam~estO.PUbGCUkNfies. The permk holder understands end agrees that granting this permit is not a warranty or reprosentation by Msti<y tltiat the project will be safe of satisfactory By ' The permit holder understands and agreesthat the:City shall hav@.;he right to make periodic inspectiOh ~ duNttg construction. ff the permit holder do@srtW.mske arrangernentfa the inepi:ctiat the.City may tum Ii otf the water until such Inspection has been made.. f f p:.~ _ yes. . F ._,~---+.T+'-. ~~.n ~r.. a.p, ..c ..~..,i ,-a ~.~-,z: _ x,~._ s. ...,~,.,T_ . Std, ~ ~ , ~ ~ 1~ . ' ~ i CITY OF LAKEVILLE SEWER AND WATER PERMIT APPLICATION Date c,3G ~J Job Site Address lfg 3 ~CD /"'~i~~i~rS<L l~' Legal: Lot Block ,~oo Ad//dition Owner or Builder ~Gt.~~ CSr6 lo, Excavating Contractor / ptoct'`~ ~1~~ ~k~S Tel. J~S~~ d(7S Address lY~.~ fl 0~3~240 .dir.. I~• Citq ~`~y ~t~uS~t, Zip ~ b g ~ Private Sewer System ($29.50 + .50) $ ~ ~ Private Sewer Repair ($14.50 + .50) $ - '3 i~~ City Sewer & Water Connections* (29.50 + .50) . $ ~q; ~ 0 `1 ~ Inside Plumbing Conversion (15.50 + .50)• $ v Sewer Connection Onl ($14.50 + .50). $ Water Connection Only ($14.50 + .50). - $ Meter ($60.00) & Pressure Reducing Valze. $ * Metro SAC Charge S/W Connection Units $ TOTAL CHARGES $ 36 °G'"' Is Street Excavation necessary? Yes No Signed 3G /mar f?' ~d~~ 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) 469-4431