3265 Random Rd - Tie In Card EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION ��
Date: Number: Q
Billing Name: Site Address: 3 (e 5 RebiK , /
°M 4
Owner: Billing Address
Plumber: .
• l} z'" A4 J.4 4tsr
Meter Size Connection Chg.
� Meter No. Permit Fee'
1 1 Meter Reading Meter Dep.
I I Meter Sealed: Yea Adel Chg.
NO Total Chg.
I Inspected by
1 1-1 ;;;;I:;;?: , "
Date
Building is a: Remarks:
Residence
$25.00 RC N PFCTION FEF FOR
Multiple No. Units HMPROREtLY INSTALLED GILTERS.
Commercial
Industrial By:
Chief Inspector
Other
/
In
consideration of the issue and delivery to me of the above permit, I
hereby agree to do t1e proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
By:
' Please notify the above office when ready for inspection and connection.