3595 Blackhawk Rd 3830 Pilot Knob Road TER SERVICE PERMIT
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: -
Zoning: _ No. of Units:
Owner: —
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
agree to comply with the City of Eagan Surcharge:
Ordinances. c - D jK Misc. Charges:
�, \ Total:
By �- -�J Dote Paid:
cs
Date of I nsp.: 1 l — (r-� ? Insp.: