3955 Riverton Ave - Tie In Card A. RAGA); TOWNSHIP
3795 Pilot Knob Road
St. Pqul, Minnesota_ 55111
T ele ph one 454 -5242
• ERp11T FOR WATER SERVICE CONNECTION
Date: Number• 92'3
1111 �r ' sue ^, {}
Billing(Naame(.�Q � ® A Site Address: -`�? '
Owner: 4 e c i. 1 .��.` e i Billing Address /,I1, �i`N- k(" A•r:4) 4 .Q+
Plumber: MOM? y'
t� i& 1, 1')
/
Locption of Connection Meter Size Connection Chg. 300,00 ,d 8402
Meter No. Permit Fee 10.00 8 2
Meter Reading Meter Dep. 7 2 s/o
Meter Sealed: Yea ✓ Add'l Chg.
3 3 4 A ..1 Total Chg.
Inspected by
b$b ✓ 7 S/D Date /D -/3 7
Building is a: Remarks:
Residence
Multiple No. Units
Commercial
Industrial By:
Other Chief inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do tte 'proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota. ( �
By: Cc). (7Q) .t
Please notify the above office when reedy for inspection and connection.