1412 Balsam St - Tie In Card
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EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date: i c:Herctr 21, 1970 Number: 523
Billing Name: 'Pilsen BoiuQs Site Address: 1412 t3als.~ut
Owner: same Billing Address aaiv--
Plumber: Ceora,e J, LuQCken
Location of Connection Meter Size Connection Chg.
Meter No. Permit Fee 1C.UU gd 12/21/70
Meter Readinpr„-_ Meter Dep.
Meter Sealed: Yea Add'1 Chg.
3 ~L sz ' NO Total Chg
Inspected by
Date 1`70,7
Building is a: Remarks:
Residence
Multiple No. unite $25.00 RE-!T:"?ECTIOCI FE FOR
IMPROPERLY 'iSTALLED 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.
By:
Goorgu J. Luocktn
No. St. Paul
Plesue notify the above office when ready for inspection and connection.