1835 Jade Lane - Tie In Card
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242.
PERMIT FOR WATER SERVICE CONNECTION 9-5-1
Dater Number: d62
Billing Name. ~CCl XLt ~ -~I Site Address:
Owner:
BillingAddresaf
Plumber f i l~a.~~.l~V\ i~ •~~~'~7,1
Location of Connect on Meter Size Connection Chg. 7/3/72
Meter No. Permit Fee 1G.(ri u3 7/x/72
Meter Reading Meter Dep. 12
Meter Sealed: Yes_ Add'1 Chg.
jo ND Total Chg. Inspected by
Date
Building is a: Remarks:
Residence xx
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 rules and
regulations of Ragan Township, Dakota County, Minnesota.
t
By:_
Please notify the above office when ready for inspection and connection.