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.