HomeMy WebLinkAboutNo 10597
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City of Lakeville August 12, mss
N° iQS97
INSPECTION DEPARTMENT
Penaeit Fae.......... 29.50
SEWER AND WATER PERMIT ~ so
A N D R E C E I PT State srrrehotrge
TOTAL FEE PAID . :30.00
Permission is hsroby grented to ~ymaLth P1 nmb3ngl,IQ~~'i?
1 1 Pr Constr
Buildiny'on Lof No. - t $i. 8iock Subdivision onna~ s Valley Park 8th Addis
Paweel ~~22-21177-180-11 Pat
in the CITY OF LAKEVtt.IE to be used as p_,e, it "ta connect ° to city roster .and sewer system
This permit is issued on the express condition that the -ERECTION ,.ALTERATION -..REPAIRS
i$ INSTALLMENT .-MOVING ~DEMQLITION respects to the statements certified to in thr application for
such permit, and that all work shall be donee in accordance with the Ordinance of LAKEVRLE, Minnesota and the Stale
of Minnesota pgrtainn~ to -the construction of buitdin,?s.
Street Address' 16~G4 FAbFRt~#t,R„ ?pstenu,e r_i e T nnon~j,
Attentionta petdcularly called to the rotting up of sGeets, making main sewer conrrections, d6veways and Director, lisenae amd lmspeeNon
cribs: Ubtekl paemR for such. construction from ttre CITY OF LAKEVILI.E. Inspectan Department Not
Rasponsibte For Any Dmnages toPublic Ugliti®s.
ThepermM.holder underot~ds and agreesihat gr~ntingtM1is permit snot a warranty or representation by
the City filet the projectw~ be seieor satisfeciory
BY ...yi
Th6 permit holder understands and agrees that the City shah have the right to make pbriodic inspection
during construction. Hthe permit bolder does not makearrangemeM. for the inspection the City may tum
off the water until such Inspectbn has been made.
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CITY OF LAREVILLE
SEWER AND WATER PERMIT APPLICATION
Date /
Job Site Address /6,~~!~
~j~i~
Legal: Lot Block Addition
Owner or Builder ~+e /fit 1~~~'"
Excavating Contractor %~~y,tisa I~'1? ~l uwr!?~/i ~t
Tel . _t~s+s1 3l~.~
Address 14f~t,~ fj ~~A,/ ,Qv.• ~ City ~l~,~i~ Jl~ Zip ~'"y1~
Private Sewer System ($29.50 + .50) . $
Private Sewer Repair ($14.50 + .50) $
City Sewer & Water Connections*(29.50 + .50). $ 3 p,D~
Inside Plumbing Conversion (15.50 + .50)• $
Sewer Connection Only ($14.50 + .50). $
Water Connection Only ($14.50 + .50). - $
?deter ($60.00) & Pressure Reducing Valve. $
* Metro SAC Charge S/W Connection Units $
TOTAL CHARGES $ 30
Is Street Excavation necessary? Yes
No f(
Signed ~~~4~..-•-r
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