2837 Lexington Ave - Tie In Card 11
il
2/0 Cti - 7010 C e j
3795 1p Knob Road
TOWNSHIP
\
St. Paul,
Minnesota 55111
Telephone 454.5242 �( L 1 1 .� Q ,
PERMIT FOR WATER SERDICE CONNECTION —7-- L - ' " _ ' ��'"f ^,
Date:
Number:
Billing Name:
�a,3�� -�.� Site Address:
Owner:
Bills °
Plumber: ng A ddr ess
Location of Connection
Meter Size ------ Connection Chg.
No. ---- Meter No Permit Fe
/Idv5/
Meterf�- ----!�
s 4
x Reading______ Mater Dep.
�i of
EC Meter Sealed:
� Yee Add' 1 Chg,
— i ui •
•
Met
• µl i� Total Chg.
o ( ' i Ittspected by
P :
4, Date
Building is a:
Remarks:
Residence
—pot-. Multiple No, Units
Commercial
Industrial_
Other
By:
''� Chief Inspector
In consideration of the issue and delivery to me of the above
hereby agree to do the proposed work in accordance with
regulations of Eagan T Permit, I
o�mship� Dakota County, Minnesota, the rules and
By:
Please notify the above office when ready for inspection and connection.