3996 Palisade Way EAGAN TOWNSHIP
3795 Pilot Knob Road
.e •, Minnesota 55111
Telephone St. Pe 454.5242
PETIT FOR SEWER SERVICE CONNECTION 11Cl-
DATE: ld ll?t
i
k) �.4F? -� �+3 Address
OWNER. 1 �" 11,
• I TYPE OF
PLUMBER ( r ),.v1
DESCRIPTION OF BUILDING
Industrial Commercial Residential
Multiple Dwelling No, of units
ztiu.aa pd
i /zz/7z
Connection Ct�ar6a� ---"
Location of Con nectioass 10.00 pi 8/72I7z
Permit Fee
Street Repairs
Total
Inspected
Date L _ LZ` - 2
gemerka:
By Ghief Inspector
In consideration of the issue and delivery to me
of the above Permit. I
hereby agree to do the proposed work in accordance the rules and
regulations of Eagan Township, Dakota County
B y \ 0 `" 1 . " ( ,
Please notify when seedy
for inspection and connection and before any portion
of the work is covered,