1500 Lone Oak Rd - Tie In Card EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date: er.t :bcr 1G, 157U Number:
Billing Name: !Lrit.t sw n Site Address: P. ! 1 r , i r;9i 11
Owner: ra Ss.,a., Billing Address
Plumber: h:.,>,, C ;a Treueili ,
Location of Connection Meter Size Chg.
Meter No. Permit Fee .
Meter Reading Meter Dep.
/- S 8 6 Meter Sealed: Yes Add'l Chg.
NO Total Chg.
Inspected by /C
es* n•k Date g - 3 0 - 7(1
Building is a: Remarks:
Residence cc .
Multiple No. Units
Commercial
Industrial By' 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.
7