3922 Beryl Rd - Tie In Card 2 -2 -s
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR SEWER SERVICE CONNECTION
NUMBER ///
DATE:
Address
OWNER:A
TYPE OF PIPE
PLUMBER
DESCRIPTION OF BUILDING
Industrial Commercial Residential Multiple Dwelling No. of units
1 00 � Pd•� /
Connection Charge__ -
Location of Connections: ,i
Permit Fee
Street Repairs
Total °�
S ' )�D
Inspected
Date
Remarks:
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 accordaance ith the rules and
regulations of Eagan Township, Dakota aunty, Minneso
sy
Plsase
notify when ready for inspection and connection and before any portion
of tha work is covered.