4280 Lodgepole Dr - Tie In Card EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date: M
:071 Number: > c.)0
Billing Name• Wet uu eGa,tructicu Site Address :I. -i [.<< , -':olt t (1:.30 11acnlo,.:
Owner: suuu: Billing Address
Plumber: SJeuzc:Y I'1LUVVir:> k Iteatinr; Inc.
Chg. `° "• "" Pu 5/20/71
Location of Connection Meter Size Connection
Meter No. Permit Fee 10,i'') ,, 6 /1/71
Meter Reading Meter Dep.
Meter Sealed: Yea Adel Chg.
yQ
3e-/ NO Total Chg.
Inspected by � , _ �
Date • �f/f/�'
Building is a: Remarks:
Residence,'0 $Z5.03 11E-INS EGTlON FEE FOR
Multiple No. unite IMPROPERLY INSTALLED METERS,
Commercial
Industrial By: Chief Inspector
Other
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do tte proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
By:
i7ccnzel 1'1uc:;bic. iioatin,c l::c.
Please notify the above office when ready for inspection and connection.