1364 Wilderness Run Dr - Tie In Card E•GAN ot Knob TOWNSHIP
3795 Pil Road
St. M�.oneeota
Telepbsie 454 -5242
PBRMiT PDR WATER $BRVIC$ CONNECTION
A` .Dotes Marsh 27� =1 972 Number: 793
Hill ng"Name Wanmt4tul Conatruo S ite Addr 1 3611 Wildern It
Dr1re
Owns. esm6 - Billing Address
Flumbes: Wenzel Pl & Heating'Inp,'
4
lo cation o Connection Met Sine Connection Chg. 300.00 3/72
Meter No. Pe De ee 10 B/72
a " Meter Re - ' Metes Dep. � 2 f7
' Meter Sealed: Yea Add'1` Chg.
NO Tota Chg.
Inspected by
Date f! y - 11
• Building #§ e: Remarks:
Residen 1
$25'
RE , lt's r I L�
Multiple _ ` No , V nita! J i � 1Pl�J�'�• �Y ![ +.t.. ,....E �•
Commercial
Industrial By:''
Other Chief Inspector `.
In of he issue and del ivery to me of the above permit, I
hereby agr to do the proposed Work in accordance wi the rules and
regulations `of Segall Towuehip. Dakota Coun Minnesota.
By:
Wenzel P lumb inN & 'iieatinrz Ina.
Please notify the ab office when ready for inspec and c onnect ion.