4072 Halite Lane - Tie In Card
&GAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Data Number: 1007
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Billing Name•~ Site Address:
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owner: _ Billing Address ! t• y `re
Plumber.? i j1 1 C1l i~ t t~Q
f Connection Chg. 10/10112
Location of Connection Meter Size
Meter No.Permit Fee 1(.i,Dti 1 1i;%10/?2
/7z
Meter Reading Meter Dep.
Meter Sealed: Yea Add'1 Chg.
3~0 3N j NTotal Chg.
inspected by
Date- 1Z- A - P i~ -
Building is a: Remarks:
Residence = ~nct N FEE FOR
.)•~0 R~,
ihtr'R~r~rtY li,~(A(-lEt~ PAETERS.
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 tba proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota..
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Please notify the above office when ready for inspection and connection.