4136 Meadowlark Lane - Tie In Card EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date: July 12. 19'0 Number: 891
Billing Name : 1 le 10.4z. 3 Site Address: 1.e1 eu ' -' ., t-
Owner: a:,4 Billing Address
Plumber: biusmrke 'Prealohivg Xx LI.4avait]n„
Location of Connection Meter Size,_ Connection Chg.
Ewa /J•.,r ',
Meter No. uj <" Permit Fee 1J•eo
Meter Reading Meter Dep. ' . ")
ji1 Meter Sealed: Ye _ Add Add' Chg.
NO Total Chg.
3 Inspected by
ft2e- Date
Building is a: Remarks:
Residence
Multiple x No. Unites c 'Tow ou,$ -L; $2500 GE -INSPECTION FEE FOR
Commercial IMPROPERLY INSTALLED METERS.
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:
Trendi 2... v =.tin
rife the above office when ready for inspection and connection.