1411 Balsam St - Tie In Card i 0 "es
V `.y
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date: J;cei�bur 21, 1'70 Number: 52
Billing Name: Tilscu l;aras Site Address: 1-'.11 A 1-.,,
Owner: Billing Address ...„
Plumber: e...0.7 , ; t J. 1,14,“4.11
Location of Connection Meter Size Connection Chg.
Met. Permit Fee "l7U
Met_ Meter Dep.
Met No er Sealed: Yea_ Add'l Chg.
S1 0 Meter Reading
iii No Total Chg
Inspected bc .------
g 4 IJA Ml Date / Y „ 30 70
Building is a: Remarks:
Residence_
Multiple No, unite_ ;25.00 RE NSPECT'ON FEE FOR
PROPERLY INS ALLD METERS.
Commercial
Industrial By:
Chief Inspector
Other
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.
7, i
By
Guort J.. L ueck::u
.xo. St. Pa41
Please notify the above office when ready for inspection and connection.