HomeMy WebLinkAboutNo 10329 r
City of Lakeville sap,rPmber 27, ~ 84
N° 10329
INSPECTION DEPARTMENT
Permit Fee 29 . SO
SE1N'ER AND WATER PERMIT
State Surcharge , j 'SO
AND RECEIPT
TOTAL FEE PAID . 30.00
Permission is hereby Qrahtsd tc ..Plymouth Plumbing / Jo S, I ~ ~ ~ ~ Cf~ tJ S
Building on Lot No. ~ ~ Slock 6 SubdiJis~on Donnays Valley Palk 8th Addn
Paigce4 ~p22-211730-06 I Plat
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in the CITY OF LAKEVILL• E to be usdti as Parm1 r rr, t~nnrm~r rr, r~~ se~taer ~El~ 'wB~Gs~' s~s-Tze~t-----
This permit is issued on the\cxpress condition that the _Et2ECTION _ALT€RATION „^REPAIRS
INSTALLMENT MOVING ~DEMOLITIONrespects to the statements certified to in the application for
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such permit, and; that all work Shalt be done in aecordancewith the Ordinance of LAKEVtLLE, Minnesota and the State
of Minnesota pertaining to the cdnstruction of buildings.
Street Address 16409 Farcry Way Glenn A. Lan~vand
~ Attention s particulerty called to the cutting up of streets, making main sewer connections, drweways and Director, Li£Itnfte acid ]nt~tflon
curbs. Obtain permtt for such constructbn from the CITY OF LAKEVILLE ItiSpectipn Department Not
Responsible For Any Damages to Public UtiNties.
The permit holder understands and agrees that granting this permd is not a warranty oHl;presentation by.. a~_F'.~-Y
the Gty that the project wiN be safe or satisfactory. By f
The pannlt holder understands and agrees that the City shall have the right to make penodic inspection
during corretruction. tt the permit holder door not make arrangement for the inspechontheCity cum
off the water until such fnspectim has been made.
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CITY OF LAKEYILLE '
,SEWER AND WATER PERMIT APPLICATION
Date a?(,
Job Site Address _ ~~,gy~~y j,~y¢~
Legal: Lot Block Addition
Owner or Builder l`~--- "
Excavating Contractor ,f-~,~^.~-z-~ ~ Tel._
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LY L./ ? ice. ~`-fl d ~
Address ~~~a ~ 3ti city. zip
Private Sewez System ($29.50 + .50) $
Private Sewer Repair ($14.50 + .50) $
City Sewer & Water Connections*(29.50 + .50). $
Inside Plumbing"Conversion. (15.50 + .SO)- $
Sewer Connection Only ($14.50 + .50). $
Water Connection Only ($14..50 + .50). - $
Meter--($b0.00} Pressure Reducing Pal~re. $
* Metro SAC Charge SIW Connection Units $
TOTAL CHARGES $
Is Street Excavation necessary? Yes
No
Signed G~iJ.~s~~~/~~~~~,
Make checks payable to: City of Lakeville
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Send payment to: City of LakevilleGlenn A. .(Barney) Langord
Inspection Dept. Plumbing ~ Heating Inspect.
" Box 957 "
i Lakeville, MN 55044 Tel: (612) 469-4431
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