1073 Keefe St - Tie In Card /Va /, ..—
e.4, a { c e4:%1 , 2€t— 4 OV
RAGFdt 1150SH Road . vs'7(: � n , /C d4 i /
3795 Pilot Knob VVVV
St. Paul, Minnesota 55111 gam/ �� �N r^ 1+ c .1 ✓ I;r
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date: /Qe.. a, ? /14 7 Number: i �
Billing Name: Ci-o/10o,✓ 1343-/t/L Site Address: /0
Owner: Billing Address I.
Plumber: 39 Ht
Location of Connection Meter Size VS Connection Chg. a o o• P° ' %s/
Mater No./7321 I ' Permit Fee AO
Meter Reading /) Meter Dep. /5% O°
Meter Sealed: Yee Add'1 Chg.
n od NO Total Chg. So
3 3 � i 1 (J /�44-i
J. Inspected by / •(
0
Date
Building is a: Remarks:
p �
Residence 1 .- 67, // - 30 --6 7
Multiple No. Unite
Commercial
Industrial By:
Other Chief Inspector
In consideration of the issue and delivery to me of the above percit, I
hereby agree to do the proposed work in acco d ce with the rules and
regulations of Eagan Township, Dakota Coun Minnesota. /1 /
li By : &1t
Please notify the above office when ready for inspection and connection.