3109 Alden Pond Lane SEWER & WATER PERMIT OFFICE USE ONLY
EA+AN METER # - `.PERMIT DATE 9 / 6 / .t q
31t10- Picot Knob Rd. 10862
MN 55122_1897 °. CHIP # WATER PERMI i' # '
i METER SIZE B.P. RECEIPT C 3679
a 8/31/89
.. 8/31/89 DATE �. B.P. RECEIPT DATE
— PRV _ BOOSTERPUMP
SITE ADDRESS 3109 Alden Pond ya - PERMIT REQUITED
LOT BLOCK '2 SEC/SUB • � Jl k r fb
APPLICANT:
R�erern Cotrurtin„ Tr, -EWER TER _ TAPS . . '
ADDRESS' 17I1 W;' uM I C{3IMM / IND S IDENTIAL
, CITY, STATE - d . ' ev.11e, MN . zip 55113 - - .
PHONE: 631 -3254 W ;_ EXISTING
PLUMBER: ma jp.i. M.Qrharn i C.a 7 , Trn,
ADDRESS: ,40650 i 15l, - f AGREE. TO COMPLY -WITH CITY OF
�_ .CITY, STATE ° I , 1Qle ;r' . ' T 'ZIP 55369 £AGAN ORI3�INANCL •
PHONE: '4244680
OWNER: e
ADDRESS: 17 R. ►'- f nr " R 'd P SIGNATURE WHEN AgETER ISSUED
CITY,' STATE ' 1l a i. 1440 MAT ZIP 5471
PHON 636 - '050 ,
...n' i A
pizore
TWO ' *, r_-'. a . i , 1€ � ESSING. FOR STORM SEWER CONTACT fi ‘
c - : - . . �A^J y' ( WILL BE NOTIRED WHEN JESSE _ ' el-,.1*)