HomeMy WebLinkAboutNo 10928 ! M ~i
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City of Lakeville .7„1~ 9r ~
N°• ~ 0928 INSPECTION DEPARTMENT
SEWER AND WATER PERMIT Perm.+F~t.......... 3g.so
AND .RECEIPT s+ote s~rehorge so
TOTAL fff PAfD . 40. QO
Ptrmission it hereby prontsd to HiltneY Phimbirig/.Tgs. Miller Constr
Building on Lot No. 22 Block 11 Subdivision ~onnaXt s V~ll~y Park 8th Addn
Parcel X22-21177-220-11 Plaf
in the CITY OF LAKEVILLE to tie used as nP~"mit to connect to city water and sewer system
This permit is issued on the express condition that the -ERECTION -ALTERATIONREPAIRS
INSTALLMENT -.-..MOVING ^DEMOLITION respects 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 LAKEVIhLE, Minnesota and the State
of Minnesota pertaining to the construction of buildings.
Street Address 1h40Fi FanYAR'IA Av~mta rlwnn A. 7,an~nrd
Attentkxt ie particulerlf celled to the cutting up of streets, making main sewer connect+ons, driveways and CtRCiOI, Lit~nss and InspeCtlon
- curbs. Obtain permit for such construction from the CITY OF LAKEVII~E. Inspection Department tJOt
Reapotulble Fa Any Damages to Public UtiAtles.
The permit hokfer understands and agrees that granting this permd is not a warranty or representation by
the City that the pro}ect will be sate or satisfactory B?
y
The permit holder' understands and agrees that the City shall have the right to make periodic inspection
during construction. tt the permit holder does rwt make arrangement for the nspection the City may tum
oN the water untll such inspection has been made. -
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CITY OF LAKEVILLE
,SEWER AND WATER PERMIT APPLICATION
Date ~ ~ ~ ~7
Job Site Address
Legal: Lot Block Addition
Owner or Builder
Excavating Contractor Tel.
Address ~ ~ ! ~ ~ /~~~~~.C. City i`i~ Zip J~
Private Sewer System ($39.50 + .50) $
Private Sewer Repair ($I9.50 + .50) $
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City Sewer & Water Connections~(39.50 + .50). $
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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
Ins ection De t. Plumb in & ec .
P P Heatin Ins t
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Box 957
Lakeville, MN 55044 TeI: (612) 469-4431