4071 Amethyst Lane - Tie In Card r
EAG1N TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: )9 / c) / ( 2 H R NUMBER /161
OWNER: L:ACe,2L �1-f0,-, C'4. Address ' 'o 7/ CGr7[tTJi
��G' dpi.
PLUMBER � _ TYPE OF PIPE ��� Le,iy n , '
DESCRIPTION OF BUILDING
Industrial Commercial Residential Multiple Dwelling No. of units
' Gl"aL'�
Location of Connections:
Connection Charge _Vy, (Pj +4 /
Permit Fee 7 n
Street Repairs
Total n
"t, 4 f g y � Inspected by: L.e., y ,Ll
% i 47 Date / ?-��� `/
L J , Remarks: fl 4:-___
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
,G �GC.
Please notify when ready for inspection and connection and before any portion
of the work is covered.