3941 Riverton Ave - Tie In Card EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111.
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
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$�
Dater ,--. — Number: ` (� I 964 _
A 'Site Address:"� r.
Billing Name )� � C1`) i 4
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Owuer ✓ � \`T P ' '1 Billin Address i ) if %? C [,.) f l
1 `" _moo '� 1 V i 1.1 LI n - 4 ,c. L
Plumber: ``� (-- a J t \ 7 r
t Connection Chg. l .DO . 29/72
Location of Connection Meter Size_
Meter No.____. Permit Fee1 0 .00 d 8 2 2
. I
Meter Reading____ Meter Dep.
Meter Sealed: Yes__ Add' 1 Chg. �_-
NOT Total Chg.
0 0
2- pr3 7 Inspected by
Date a _ _' �'
Building is a: Remarks:
Residence �
Multiple No. Unit
Commercial
Iadustrlal Hy' Chief Inspector
Other ..,,.,,
is consideration of the issue and delivery to me of the above permit, I
-reby agree to do the proposed work in accordance with the rules and
egulatioas of Eagan Township, Dakota County, Minnesota.
lease notify the above office when ready for inspection and connection. i