HomeMy WebLinkAboutNo 10218 ~~e:, .
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City of LakeviEie
No ~ d~ 18 INSPECTION DEPARTMENT ,
Permit Fee 2 9.5 0
SEWER ANA W~4TER~P~RMIT
AND RECELPT state surcharge so
TOTAL FEE PAID . 30.00
Pemnission,is het•.by 9rontsd to hteGuire Mechanical / J~®. M. Miller Const.
BuiidirtQ on tot No. 13 81ock .~~0 Subdivision Donnays Valley Park 8th Addn
Parcel ~>`22-21177-13~-I0 Pint.
in°the CITY OF U4KEVIL~E to be used as Permit tb connect `to cifry sewer and water. system
-This permit is issued on-the express condition that the _EREC'fal'~N .-ALTERATION _.,,..rREPA1R5
INSTALLMENT ._MOYING _bEMOL1710Nrespecis to the statements certified to in the application for-
such permit, and that a i work shall be done'. in accordance with the Ordinance of ;LAKEVlLLE, Minnesota and. the SMte
of Minnesota pertaining to the construction of buiidin~ps.
Street Address' 16379 Fantasia Avenue Glenn A. hangord
.Attention is psrtlculerly celled to the Cutting upof streets, making main sewer connections, driveways and DirlitOr, Lilense and InsOettton
CUrbs:.Obtalnpermltforsuchcdnstruction.tromthe.CITYOFLAKEVILLE.lnspectron.DepartmanYtJOt ~ - -
Reeponeible For Atry Ddneges to"Public Utilities. i
The permit hokter understands and agrees that grentingthfs permit is not a warranty or representation by ~ f~~
the City that the project will be sate or satisfactory u
By
The permtthOld~ understands and agrees that the City shah have rthe right to make periodic mspectiort j
during conetruCtion:'ff the permH fwklerdoesnot make arrangement for they v~apection tha.City may tum
oN the water untNSUCh fnapectloh hes been made.
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CITY OF LAKEVILLE
SEWER AND WATER PERMIT APPLICATION
Date MAY 22, 1984
Job Site Address 16379 FANTASIA
Legal: Lot 13 Block 10 Addition
JOE D~TILLER CONSTRUCTION
~r~~:: u~' 13~,ilder
CARSON: EXCAVATING, I1V'C
Excavating Contractor
Address 15604 CORNELL TRAIL: City ROSEMOUNT, N~INN Zip 55068
Private Sewer System ($29.50 + .50) $
Private Sewer Repair ($14.50+ .50) $
Sewer & Water City Connections*(29.50 + .50). $
Inside Plumbing-Conversion (15.50 + .50)• $
Sewer Connection Only ($14.50 + .50). $
Water Connection Only ($14.50 + .50). - $
Meter ($60.00) & Pressure Reducing Valve. $
* Metro SAC Charge S/W Connection Units $
TOTAL CHARGES $ ~ Q
Is Street Excavation necessary? Yes
No
~ Signed ~ ~ ~lc ~.GrJiD
Make checks payable to: City of Lakeville
Send payment to: City of Lakeville Glenn A. .(Barney) Langord
Inspection Dept. Plumbing & Heating Inspect.
Box M
Lakeville, MN 55044 Tel: (612) 469-4431