3942 Blackhawk Cir - Tie In Card EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 5
i Telephone 454 -
PERMIT FOR WATER SERVICE CONNECTION
Date: i' Number: 997
Billing Name :s i'�t : �.�. >at �Site Address: > / { -D < 0 {,
Owner: ) NI; ■ Billing Address - I '1 - -/ C ' ‘`'0` ' 1 , ' C (...
Plumber: ��� ; i �1 C : i 1 ,(,
Location of Connection Meter Size Connection Chg iUU•XU 1s 9/zu/72
Meter No. Permit Fee 10 l i 9 / =
T.1„)/ .....W7,..1 we
Meter Reading Meter Dep.
Meter Sealed: Yea Add'1 Chg.
II Z NO Total Chg.
5 7
Inspected by
Date [fl "Act` 7 7/
Building is a: Remarks:
Residence ux
Multiple No. Units
Commercial
Industrial By:
Other Chief Inspector
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.
Please notify the above office when ready for inspection and connection.