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1991-003606 - water connect
�'ERMIT ��� � ; � A �$ �'��� PERMIT TYPE: 1335 Brown Rd. South • P.O. Box 66 Permit Number: ;i����)�;�� w����` Crystal Bay, Minnesota 55323 Date Issued: f�y;;;�;/�� (612) 473-7357 SITE ADDRESS: :;�5;� �I�!I td�';�1'�:1�! AVE � .�� �'. i . N. = 1%-1 f 7—y_:—:;�.—i x:;;��_� DESCRIPTION: � L��Wrc�i` t�t �ct'�•�i' �`�1'�i�1i• ���,+'}��t� �?--ii �_;; :_:;_;�•�iw_:.:_.: I��I.i�i '._�N+1J�i' c�.`�.t �ttT..r���' 1,�ii}'�:: �}'(=�t� �';�_�_�liJ[_i'�l.:f•.�. ,6� .�„��� � �,�� ��p� ���a� �� ,��„Aa �� �l�� �e� ror��'� l��x ii ,�� � � � ��� p� #*�4�"� �� �. �a�° � .� �� c �*� � "��'a r�r ti'.�,�; �� �� �a- �'�t ,��`���' ���'P""�����x ��i� "������z� -� � � � rv a���"�i �c��i�1e��� dr�,���y����&'����''�C va��"k+�'��'�',`' . �'-�/ A��'��Y'*^4�Ti�k '��y � 3-.�'�M Il k"�u�/,. ` ?d� Ly� � i? l�x� � '�i��r�"�uv� ���t� �� ��n�� �4s� �� � : t.�t,.t '�i��iv►n �`:w���`��s'�°���t'�,� � ��'»� "' i)L �ttuU� �i�.r�v r ��'_ " ��,�� ' , bN�� �M1,,r � K �""" i'}•i•:-:�r'tftj��A ti ,�{ r �" kM �d � ' liiL.i.L�V V�V [ 1l t` ^� �#`� a„ q N ,� �� ���0� �� V 1�MJ1 �ii�t�} �� � �� ?�'�"'�w✓��(� ��,°� �h��� lA�C��,��g�.�" tliirl�� ii �J.tl a 18t a�*g. �� r,�3�'d��� � a h aharv�. �.� �`� ,.` ��.����'� � ,.'�:� �x� _ ''+�'F`�"T{��T...'F'it•' Y{(t# , ry+ ., � .�' . ..... _ ..'.��- l�L4L1! 1 1t�1�• 1YV� . , . ... . . .. .... .� . ��(� . �f j� KL Vr!�1� LV1�.L ISt�.A f 1'�!'� i�;���'iV{ REMARKS: � � FEE SUMMARY: E:a�e f ce �.:ca. ��t_� '=�u��cF,rir�� __----_ _�=5�� T�,t.�1 F�� �:;��� .�i.� ' CONTRACTOR: —� ���F•� i���+�• -- OWNER: L_An'=��=�i�i F'LE�ta I tvi: ;;:�ci.'�:'7?t;�;i i :=�FE�i'i't�Fi C:�'tt�J'�T �:�x�=�� 1�,:�PdC} Lr� PJ 4J :�:�.�.t f L I VI P��=��=��CJ �VE A�a�s���IER i���i ��::t�_� +�tA'f�ATi� �1�i S5_�9i t�.1��� ��7-7�.::t.� �i.. [! ` ta)f"" ` }�f ' S�"i'e F"[ �J [' • 1 fi �"'.k:'S'i 7 ..}.' }i��':_' � !`}�'_ �`:�fi 5���._r f�i:I�IC�..? �?���"ir-E..'•S ����3ii_:E_��' } � !���'.!�'�E�i ! ._ �'.i !^i �„� ['! {'•.. . 7 `�ri'�"�� E�A✓!P'IV 7."� . E'� F . F#�'�•.�:_ I I'"F_: !'4E_4:L_ .L�`:. F3_�f�_ !L_ _ ���t—r'•_ T t�-� 3.`�J Hf'��i.1 ,'-i1:1�'.f=.r._� :{_� 1_�ES_; t-1;__L_ 'k�.�kY:�'�•. �{�� _�E i'. ��_•f t.f_!;°it'-��.i i-§i�a{_•� {K��i'� I^t!� �.:1:-�i� f_ji." - :.�.� _. ;;}._,r._. n�.�.... r•,-•r�_ 7 :„��-� � � ,.,:.. 3 � �.�h ,n��-� r•• r �` r� � :r r.--�y, . -r-�-. t.�R'_.�� ,.i iI_. 1.E .. .I�L.�G_•_� �i!'.x.. .�*�{t-{�� �_i� �Tj j_'�{�'�iC.._.e_� ] i"3 ��'t_j J.!„_!)�*.�� .�_�i lr_ Tl�.'•�.ti 12 I'1r} ��l+� E e�. e � 'I ,� � APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �_�._� ��� _ � ._ � TEL No . 612 427 9448 Mar 27 �91 13 �35 P .01 V��� L.�i .�� � C�TY Q� 1���aSo BrOWn Rd 1 APpLZCA�IOP� ���Y P81�l+1x�S y Sox b6 ( s prystal Ra�. MN �5323 ' 11111F1r!#1MR�*�***�#Ir��*!F*��/rR'klr���*�'*+k*tk*�1k�11A'�+M�kie�k*kR**�ir�k«+k*Nk1YM'�#*�*M/r�krlr+kit i �eraY inrtxacii�b� ntiXity n4rmit� by fiai.k or in ger�an �a� tha cs�y o�lic�m. 7.. You �sy �PI Y �• M�i X etl �n app X ic� b�+ scr+t ba retiurn +m�� ha a1�tn� d y tha ■pplioat d!S� xace�v d�ow. Farrni.t c�xaa r�i i Y Y �� ��� 3. P�x�td sre na� va�id an�:i� �an xa��s a i� 4. work must not bbqin unissr the pes�nti� card ie 11vA�1db�.8 on th� fnb •�te- b. dtil��y aor�necti�ar psxmSti� m+ay Ae� ig�usd tic Xia�l���d ��If��'!ldtOrs on��►. 6. Contnct the PabXic wdrke D�par�ment t�7��'7�57� �bx utility etvb ae�buit� �.oce��iona. AQ NOT ExCAVA�E iN ANY S�REBT AND DO�N�4� �rms��doesln� qr t t�it �►pprovuX,�el of tihe � p�}�Yi� Work� Depaz��met�t. zasuAnes o P } 7• A1�. wor.k must be in peatip4abeforeei��iehaov�rsQ�adC�X$47'8�7357�• $. Z� ��� noti�� ��1tl.�ed• �r**�+t�e�k*1��**�r**Vt�h*�r*,k**!�*��rw***�rr*ik�tve*��+krr*A�Yre*s�rr*w�t���**,��*ww��r�w****A�,��k �a$ SIZ'E ADDRESS! fo �v �c.�c� �..;��r� h s+�r� �� OGoupancy �'YPe= „�,..,. es c9a+—n al �._ omm�ra�ai�— OWN�R'8 NAi�: � / . Fhone No. : - - - Mai.ling Rddre s: ���Y= G'dNTRACTaR'� �AML a sus. Pho31�4 MaiJ.ing Addresss Citiy: < Z pr �S�d ***+r�►�r,r* �w��rr�r�i *******�****�*��** * � * *w* �PBRMI�' TYPg ANU 1�8� GAr+CU�ATItnI i�NICI�Ax� SEWER �QNNUCTI0�1 t �3 U.04 p��r $tub) $ �ixo"n'— pipe s�z� inah�s = matexial �,,,�,PVC ton s���rmiit a��icatia�ns unless � SAC Chai�e (�5+75.00 ) mus� �aaompany �]� � �e��r F' �� s p��pafd. If not pz��a��� A s�wer coririectian ps�m�.� w�.X� �a� be i.�eu�d. k MQNICxPAL WAT$R CONNBCTIUN (��0 .u U p�r ��u�1 � _J� •� __....._ + p�.pe siz� _,�,,,,inche�t mater�.a�l „�„� cappex't o�her � WATER METERs mus� be pic�k�d up e►nd paid �or at Citiy a�. . (5�8�� metea�s = 5111� 30 � 3�4" m�ter� = 51�6.28) i i�s�er m�tera must b� ��t aad �ea�ed by arano Wat��r Dc�partment I473-7359) � upoa o�mpYet�att o� mete�' inetall���on. � REQL1zRED minimum se�t��� ks ��'Om ftxainfl�eld and septio tank� � 7!�' A�Q[IIRED setback �rd�ct ��wer li,ril� � 2� ' ��r*w*+�***�►�*rr����*w��***�***l���+k,k�**,r***�*1��*rr**��r���R*****rr�*�1A1tlrle*+k*��,4*�!� � � . Subtot�tx og abov� p�rm�t reque��t�d S .�------- � 2. 8tet1� �urcharge .�0 � Th� E'kate Bu�.idi.ng God� Di�'� n� w�CCr aonneot�on Fe mi� r�qu gted. � ineludnd for �a0h we11, �Awe � W 1 i c a t�.t�ri�1 � 1.5 0 ,�,�,,,.,,,,.. � 3 . pr��ta�e & 8undiing (On7.y maf 1 iri app 4 • �OTAL 1'E�tM�T FE$ (+�dd llries X�3 above� $ � � ` �� ' ��� +kdr*�t�l�*k**�'�**�*R*�Ir�kdk�ltt�tkltA�'�1rtk��lr'ktklt**Ik1kV�**tk�lkditlk#l�tlttktlr tktk � Tha undersigne9 hereby applies �.o the CiCy nf dxone� !�r i0�uana� c�t a tit��itiy p�rm�t, eglrees to da aYi work i�n ��x���$ao�grd�nd certifiea th�tiaiic$te►teme�t�C ad0 0� �hie sMquXatiors a� th+� stet� at Min , app�.ic�tfon are Comp�.et�, truM sria oorr aa.�.,m�,,,.e �,g Ar�oiicat�ti t - _ DI►��t t 2 � �