4080 Halite Lane - Tie In Card
M t.. i
MAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date: Number: 1
Billing Name--Li~ F1.i tfi, ~PV Site Address:
Owner: ~o r k1( C\?F , A`Billing Address
Plumbers '
Location of Connection Meter Size connection chg.- B/le/72
Meter No. Permit Fee Lc?.uo pd 8/16/72
n p1 ti o/72 u/c
Meter Reading_ Meter Dep.
` Meter Sealed: Yeas Add11 Chg.
NO Total Chg.i_
S
inspected by
Date
Building is a: Remarks:
Residence xx
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 the proposed work in accordance with the rules and
regulations of Regan Township, Dakota County, Minnesota,.
By:\
Please notify the above office when ready for inspection and connection.