3940 Blackhawk Cir - Tie In Card s.
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date: 741 I / Number: 914
Billing Name:- 0.. (^i•1 .( C.�; ( ' i4 . Site Addresstom(/i /(' r t,. �. k''l1 5-1.;?. l„rs
Owner. t < "•�X. t � �-� �.(' �a A � Billing Address ...7 > =� ) , CA
Plumber: a., - 1 ;1 1 ( i, � rC) ..,
Location of Connection Meter Size Connection Chgan ct' - s/16 /72
Meter Ho. Permit Pee 2ci,r irl nft.i,1J2
B /lb /72
Meter Readit Meter Dep.
,q Meter Sealed: Yes_ Add'l Chg.
3 NO Total Chg.
Inspected by
Date
Building is a: Remarks:
Residence
Multiple No. Units
Commercial
Industrial By: Chief Inspector
Other
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do tte proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
By. t .)r , `,
II r
Please notify the above office when ready for inspection and connection.