3101 Sibley Memorial Hwy i
1
i
- EAGAN TOWNSHIP
3795 Pilot Knob Road I
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date
Number: like i � a
Billing Name u
, t lrza _:c.:..uc
Site Address•��
Billing Address
Owner'
Plumber: ,:.; t : - $
Meter Size_____.___ Connection Chg•.. -+-` I
Location of Connection P Fee_1_,
Meter No.__________ .. ,�
Meter ReadimK______ Meter Dep.._,_.. ■
Meter Sealed: Yes_. Add'l Chg._____-...-
Total Chg.,........-----
Inspected by
Date
Remarks:
Building is a:
Residence_____ �2 �.�� , , '1 J_'i�LLL� f, LlE(:S.
Multiple _ No. Units
Commercial o pt�L( 1i ■
'`' ctor
By: Chief Inspe
Industrial
Other
In consideration of the issue and delivery to me
of the above permit, I
agree to do the proposed work in accordance with the rules and
regreby g
he an Township, Dakota County, Minne
ulations of Eag
By:
Please notify the be office When ready for inspection and connection.