3763 Hwy 149 SEWER & WATER PERMIT OFFICE USE ONLY
CITY OF EAGAN METER # PERMIT DATE 09/11 /90
3830 Pilot Knob Rd.
Eagan, MN 55122 -1897 CHIP # PERMIT # 11628
METER SIZE B.P. RECEIPT #
DATE y'il �� ISSUE DATE B.P. RECEIPT DATE
PRV _. BOOSTER PUMP
SITE ADDRESS 3763 HIGHWAY 149 PERMIT REQUESTED
LOT 1 BLOCK 1 SEC /SUB WEST PUB. 4TH
SEWER WATER TAPS
APPLICANT: g ov" aai-VC_6,< -•
ADDRESS: , or/f ; h s r COMM /IND RESIDENTIAL
CITY, STATE 2 P'- " ZIP �� x NEW EXISTING
PHONE: :?) 3 - s
Lawn Sprinkler Meters are to be Installed
PLUMBER: 00-^/ it d Ahead of Domestic Meters on Water Line.
ADDRESS: .6`11 1 6 Credit WILL NOT be given for Deduct Meters.
CITY, STATE 19 rill! ZIP 4
PHONE: Y'a 3 ,r s.s3 -
AGREE TO COMPLY WITH CITY OF
OWNER: i /d (/ i3k-1s1i /4 6. 4-00 I EAGAN ORDINANCES
ADDRESS:
CITY, STATE ZIP
pH 01 y E. _ _ �� . c _ e SIGNATURE WHEN uFTER ISSUED
rLEAS LLO TWO h RKI AYS FOR1 , CALL 454 -5220 FOR 'INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.