4234 Lodgepole Dr - Tie In Card EACAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION 861
Data:
Number:
Duna 1, X9
j i4 L od�-r�1�: -rclvc
Billing Name:
lila Gonutructicn ■Go. Site Address:
Billing Address
Owner:
Plumber: � z /1J(2
Meter Size________ Connection Chg.�. ..1
i0 .:0 =.i 7J2
'gig Location of Connection Pest Fee_
Meter No. �_�� --
Meter Readi °g., ---
Meter Dep.,_—.---.
I, Meter Sealed: Yea,_. Add'1 Chg.____---
3 7 _ Total Chg.� --
Inspected by _ ___________ _____________________
Date /1
Remarks:
Building is 8: 4�'
XX
Residence ...,----..- J��'iF iOY i r INSTALLED ME
Multiple _ No. Units
Commercial
Industrial
By: Chief Inspector
Other_________
n consideration of the issue and delivery
to me of the above Permit' I
agree to do tte proposed work in accordance with the rules and
of Eagan Township, Dakota County, Minnesota
�ereby 8 ' / 7
agulations -,- - .„:„../'°.- _ % kTT' -
lease notify the be office when ready for inspection and connection.