3665 Blackhawk Rd - Tie In Card
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date: 1 n 14,7n Number: ,;1 2,
Billing Name: i~ ,,I Site Address
Owner: Billing Address w6' c1, cd:hw 1 ?so< i
Plumber: doily Uwa W. rk
Location of Co ction meter Size 'j' Connection Chg. '(.'1.03 i 6/10/70
ect. V,. GO i i 6/1(/7U
Meter No. ~;~'~3 Permit Fee 'ii). 1)d 6/10/70
t`f r:. W }'d 6/10/'; 0
Meter Reading 1 l1_0'0 Meter Dep.
1
y o Meter Sealed: Yes Add'1 Chg.
NO Total Chg.
Inspected b
Date
Building is a: Remarks:
Residence a.x
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 the proposed work in accordance with the rues and
regulations of Eagan Township, Dakota County, Minnesota.`.,
By
L. Pond
Please notify the above office when ready for inspection and connection.