2810 Beam Lane - Tie In Card
MAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PMnT FOR WATER SERVICE CONNECTION
Humber:
Date: ~ i
a,r•. i;:,.; Site Addreae:
Billing Name: ' '
Billing Address
Owner:
Plumber: 1 ,;.a fr,+
Meter Size ~,,T.~ Connection ~ -
Location of Connecti_onba/ C 4. b/a:i/71
Meter No. permit Fee~-
/d/7l
i~ Meter Reading Meter Dep.
6 c~ GI X 171
6q., Meter Sealed: Yes_, Add '1 Chg.-
-ND _ Total Chg.
E FOR
RE IN INSTALLED METERS.
1 ,r;;iPERLY Inspected by
Date
Remarks:
Building is a:
Residence RE.INSPECTION FEE FOR
Multiple _ No. Units $25.00
IMPRDPE~LY INSTALLED METER '
Commercial
Industrial Bye Chief Inspector
Other
and delivery to me of the above permit,
In consideration of the issue I
hereby agree to do tte proposed work in accordance BOtg.tha rules and
regulations of Eagan Township, Dakota County, Minns
BYE
Please notify the above office when ready for inspection and connection.