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3923 Blackhawk Rd - Tie In Card EAGAN IOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454 -5242 PERMIT FOR WATER SERVICE CONNECTION Date: / Billing //Name : Site Address:.57( 4 7 Owner•ai - i.' Billing Address Plumber: J i-V //gra. Location of Connection Meter Size Chg. 210. 7.50 Meter No. Permit Pee Meter Reading___ Meter Dep. Meter Sealed: Yea Add'l Chg. NO Total Chg. l� t' Inspected by spi Ivor Building to a: Remarks: Residence / Multiple No. Unite Commercial Industrial By: Chief Inspector Other 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: Please notify the above office when ready for inspection and connection.