4265 Sequoia Dr - Tie In Card EAGIN TOWNSHIP
3795 Pilot Knob Road
St, Paul, Mthnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date Maroli 18. 1g7p Number: 41n
Billing Name liiohaxd Rrnrlwd Site Address; 4265 Sequoia Drive, Evergreen P
Owner: 1 >4,.s.,,..d ri ..,.. Billing Address 4394 Sequoia Drive
Plumber: Ili chn Rnwi m,ii
Location of Connection Meter Size Connection Chg. z3U.W pd 3/t
Meter No. Permit Fee 10.00 I4 3/18/7°
Meter Reading Meter Dep.
it 4 ',,.. , Meter Sealed: Yes_ Add'l Chg.
1 \i,a_ i
'l 3 o NO Total Cbg.
Inspected by c fo
s� c n /.4 Date / 7d
Building is a: Remarks:
Residence 'x
Multiple No. Units
Co* ercial
Industrial By:
Other Chief Inspector
In consideration of the ieeue and delivery
' to me of the above pereit, I
hereby agree to do th: work ' in accordance witb rules an
regulations of Eagan Townahip,,Dakota County, Minnesota.
BY:
Richard Rowland
4394 bequoia Cmive, St. 'Paul 55111
Please notify the above office when reedy for inspection and connection.
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