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