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4040 Beryl Rd - Tie In Card EAGAN TOWNSY.IP :795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 / PERMIT FOR SEWER SERVICE CONNECTION d DATE: 4 ~~l 1.Ci "-NUMBER OWNERS ~ • Address 9 ;S S yv'/L1 v PLUMBER TYPE OF PIPE C~1 G DESCRIPTION OF BUILDING Industrial Commercial Residential Multiple Dwelling No. of units Location of Connections: Connection Charge a 0- d2.1 '1714,' Permit Fee ~J. Sa y~~~~~ Street Repairs Total Inspected by: Date /?//G (7 _ 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 accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota BY_ ~-O Please notify when ready for inspection and connection and before any portion of the work is covered.