1854 Jade Lane - Tie In Card ELAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date: j r' II 1 74 (('�1 Number: 1080
Billing Name:OYA(1(� �."si`C1�1P Q 11S - ►Site Address :I HL/ , ' 1 ' k P ) -- ll I\
Owner: c Billing Address/. _ ( . J )flC I ;fA I)
Plumber: ` _"ANIIIS 1 \ 1 •
Location of Connection Meter Size Connection Chg. JUU.0U pd 12/11/72
Meter No. Permit Fee 10.00 pd 12/11/72
.S0 pd 12/11/72 s/o
Meter Reading Meter Dep.
3 f:4111 3/ 2- Meter Sealed: Yes_ Add' 1 Chg.
NO Total Chg.
Inspected by
Date /-.2`f-...n
Building is a:. / Remarks
Residence Y
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 ( , r ,
Please notify the above office when ready for inspection and connection.