4012 Limonite Lane - Tie In Card EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
der l�it3
Date• *` .: / ' ,
Billing Name: Site Address:
Billing Address;
Owner:
Plumber:
Meter Size Connection
Location of Connection - --- --
Meter No. Permit Fee 4 / 6 / 0
Meter Reading _ Meter
l Meter Sealed: Yea Add'1 Chg.
NO Total Chg.
yo .S7 "--
Inspected
L_ A/
Building is a: Remarks:
Residence xx
Multiple No. Units
Commercial
Industrial B y' 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.
By:
Please notify the above office when ready for inspection and connection.