1921 Jade Lane - Tie In Card 4
EACAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date: Jun pr 1971 Number: 6 4
Billing Name: Sally co, Site Address: 1 1,� �,. r,.,, i,,t
Owner: Billing Address
Plumber: » ,. t.
Location of Connection Meter Size Connection Chg. nd 6/2,d71
DID .40T FAY a6O.W for 1112,114 Meter No. Permit Fee „ n i 9/17/71
Meter Reading_ Meter Dep. •3� i� �117/yl
,..d S/17/71
/� Meter Sealed: Yes Add'l Chg.
Li g- ' 33 NO Total Chg.
Inspected by 0
Date
Building is a: Remarks:
Residence X
Multiple No, units $25.00 RE- INSPECTION FEE FO"
Commercial _ VIPRQPERLY INSTALLED METER'
Industrial B
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 Eagan Township, Dakota County, Minnesota.
By:
r 'ls�btu C�.
Please notify the above office when ready for inspection and connection.