HomeMy WebLinkAboutNo 10350 ,
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City. of Lakeville October to ~ 84
N~ ~ ~ INSPECTION DEPARTMENT
Permit Fee.......:... 529.50
-SEWER AND WATER PERAAIT .so
AND R EGE I PT state sturcho?ge .
TOTAL FEE PAID . $30.00
p.m+is•ion is hsr.by grontsd to Plymouth Plumbing / Joe Miller Const.
tiding on Lot No. 15 Block 10 Subdivision Donnay's Valley Park 8th Addn.
Parcel 22-211?-150-10 p?at
in the CITY OF LAKI=1ltLLE to be used as -f Prmi r to connect to cites aew~r & water S.gs~e~a
This permit is issued on the sxpress condition that the ,.ERECTION -ALTERATION REPAIRS
R INSTALLMENT ,,,-MOVING _..._DEMOLITION'respects #o .the statements certified to in the applieatiom-for
such-permit, and' that ail work shall be donee in accardancewith the Ordinance of LAKEVILLE, Minnesota and ht Sfste
of Minnesota pertaining to the construction of buildings.
Street Address 1 634 nt•A>gia Ave ('1 r±~r+ A _ L.a~±~erd
Attentions partlculerty Called tO.thg cutting up of streets, making main sewer connecfions.drivewaysand DirgCior, t.iunse and lnrpgCtlon
curbs. Obtain permit for auchcdnstruction from theCITY OF LAKEVILLE. Inspec4on DepartmentNOf
Responsible For Any DatnapestoPubllc Utilities.
The pennA holder understands and agrees that granting this permit ~s not a weRarrty or representation by ~
the City that the project will be sate or~satistactory. B 1
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-lt9.permlt holder understands and agrees th31 the City shalt have the right to make periodFC inspectiai
dtsing construction. N the permit holder does not make arrangement fd the v~spection the City may. ttim:
- ott the water until such Inspection has been.mede.
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CITY'OF LAKEVILLE .
,SEWER AND WATER PERMIT APPLICATION
Date ~'c~~'~_
i ---~-T-
Job Site Address ~~.3 ~3 fhTi9s: ~
Legal:. Late /S Block /p Addition (ionway;! ,Q~~i'~~,?
Owner or Builder .c~J. 'Zip,
Excavating Contractor ,G/ ? n-> ~.f TeI. J
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Address _~~1 c~~ ~ ~_3~ City, - ~.:~--t_
.{.~~I~t
Zip ;~~~7
Private Sewer System ($29.50 + .50) $
Private Sewer Repair ($14.50 + .50) $
City Sewer & Water Connections*(29.50 + .50). $
Inside Plumbing~Conversion (15.50 + .50)• $
Sewer Connection Only ($14.50 + .50). $
Water Connection Only ($14..50 + .50). - $
Meter-($b0.00) Pressure Reducing Vahre. $
* Metro SAC .Charge S/W Connection Units $
TOTAL CHARGES $
Is Street Excavation necessary? Yes.
No _,x
Signed _.l,t~~~~~-lll/ ~dtioQ~.J ~ ,
Make checks payable to: City of Lakeville
Send payment to: City of Lakeville Glenn A. .(Barney) Langord
Inspection Dept. Plumbing & Heating Inspect.
I~ ~ Box 957 , _ _ r
Lakeville, MN 55044 Tel: (612) 4b9-4431
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