1909 Jade Lane - Tie In Card EAGAN TOWNSaIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date: Seams 19 71
Number: 711
Billing Name: S•Il Cot nHpUY
Site Addreee: 1 .91)9 55l 'l2
Owner: e,;me
Billing Address
Plumber: 'Chonpbo21 Pivaibiug Co.
Size
Meter
Connection Chg _ v /
Location of Connection ii � . po nd 5/13/
Meter No. 0.00
Meter Reading______ Meter
_,
A Meter Sealed: Yea Add'1 Chg Permit Fee .� --
3r J W Total
Inspected by
• Date
Building is a:
Remarks:
Residence "'° $25.00 RE INSPECTION FEE FOR
Multiple _ No. Units
IMPROPERLY INSTALLED ME [al
Commercial
Industrial B y ° Chief Inspector
Other
In consideration of the is and del is rcct ofwt the a bove p I
hereby agree to do the proposed Minnesota.
regulations of Eagan Township, Dakota County,
By:
i hom sera Plumb Co.
Pleaae notify the above office when ready for inspection and connection.