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4120 Meadowlark Lane - Tie In Card EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION Date: Jul), 12, 19'7° Number: 891 Billing Name: Is:fuz'a-1ii17 ~rml:le Bld33. 3 Site Address let Owner:; Billing Address Plumber. a e;i& ike Prtsfx llisfb rc Esc ave~tln Location of Connection Meter Size Connection Chg. ' Mete 1 No. L o 1 Permit Fee 1;i Gj~~,,,_ j Meter Reading Meter Dep.'' Meter Sealed: Yea Add'1 Chg. n q 1 No- Total Chg. q1 inspected by Date Building is a: Remarks: Residence Multiple r. No. unitst c ZUNfil=° ~ $25.00 RE-INSPECTION FEE FOR Commercial IMPROPERLY INSTALLED NIDERS. 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: 0ui.ark Teen cs 3 : * & vaa3r tify the above office when ready for inspection and connection.