4034 Amethyst Lane - Tie In Card EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR SEWER SERVICE CONNECTION ,gyp
DATE: , 3D � 9L
/�.�f 4, NUMBER ' 269
OWN ".4X Address /7-/a-.S
D 4/6.3r .(�nro./.(s
PLUMBER 1 Gill( TYPE OF PIPE ect.t..G — IIA/X,
DESCRIPTION OF BUILDING
Industrial Commercial Residential Multiple Dwelling No. of units
X
Location of Connections: Connection Charge
Permit Fee
Street Repairs
2> Total
Inspected by: A
3 4t1 Date t) /(t t
Remarks:
By
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County Minnesota
By
Please notify when ready for inspection and connection and before any portion
of the work is covered.