1061 Beatrice St - Tie In Card EAGAN TOWNSHIP
3795 Pilot Knob Road --)-Ae44 c —
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date: Oct. 2 4, 1 9 6 7 Number:
Billing Name: Joseph Cota Site Address : 1061 Beatrice
Owner: above Billing Address above
Plumber: Genz & Rvan
Location of Connection Meter Size '57/5 Connection Chg.*200.00 Pd 10/24
Meter Nole 73) -5-9f Permit Fee 7, so Pa '%4a
Meter Reading )'7 Meter Dop. 15.00 Pd. 10/24
Meter Sealed: Yes Add'1 Chg.
so f. co-ed
331' 3/` /401-0 NO Total Cbg. ,4� : a i •� °,
/ Inspected by/3.
Date //JPO
Building is a: Remarks: (:)
Residence
Multiple No. Units
Coucurcial
Industrial By:
Other Chief Inspector
In consideration of the issue and delivery to me of the above percit, I
hereby agree to do tte proposed work in accordance with he rules and
regulations of Eagan Township, Dakota Coun ; , Minn ;o :.
By: , 4"
Please notify the above office when ready for inspection and connection.