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3060 Loon Lane - Tie In Card EACAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454 -5242 PERMIT FOR WATER SERVICE CONNECTION Date: . , 1 1 i Number: Q /1 Billing Name: Site Address :.36(oO.:4*f#P �QA� Owner: Billing Address Plumber: ..._.__ -in Location of Connection Meter Size Connection Chg. Meter No. Permit Fee li i .; Meter Reading Meter Dep. Meter Sealed: Yea Add'l Chg.--. L NO Total Chg. Go R„ Inspected by 1 Date Building is a: Remarks: Residence XX Iu3 Multiple No Unite , 111:;11 Commercial Ifs °CRO Industrial By: Other Chief Inspector 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: 11..ch3 P1iu ,z Please notify the above office when ready for inspection and connection. . Y 3