4295 Lodgepole Dr - Tie In Card EAGAN TOWNSHIP
A 3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PELT FOR WATER SERVICE CONNECTION
Date:__1111. .. a i�7a
Number:
Til 1ntruti
s 4n Csc_ o _ l � 11 s Site Address T
i;.vLc�rcu 1'k.
Billing Name:
Owner: sacac
Billing Address
Plumber: Lwr
Excsvatin? Co.
Meter Size Chg. ;'' lL .f bl7 /7
Location of Connection _ ,,;I � Tj 1 ermit Fee 4:.J
Meter Permit If f'77"7T7 a/c
10\e/1 Meter Reedit: L.__ Mater Dep._ ■
Meter Sealed: Yes
. " NO_ Total Chgs—
�� Inspected by
Date
Building is a: Remarks:
Residence :opt $25.00 RE-INSPECTION FEE FOR
Multiple _ No. units IMPROPERLY INSTALLED METERS.
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.
Lc4 u. a ta.L v.titl ', Co,
Please notify the above office when ready for inspection and connection.