3966 Riverton Ave - Tie In Card „ PAGAN TOWNSHIP
3795 Pilot Knob Road
St. 'Paul, Minnesota 55111
Telephone 454 -5242
PERMIT TOR WATER SERVICE, CONNECTION.
I I Icy 4417 Number: 1055
Billing Name: \ +.Anr (jc' Q Addreas:,C?lnln /1 I Q /'TU .
Owner: \'ne Billing Address . 1. rl1Ci>f [_.
Plumber: \P1 f1�Y1IYlc1'
Meter Size Connection Chg. '300,00 do 11/2$/7.
Location of Co ctiou --- ----
Meter No. � Permit Yee 10.00 pd 11/28/72
.50 pd 11/28n2
� Meter Reading, Meter Dep.
Meter Sealed: Yea_ Add'l:Chg.
NO Total Chg.
• Inspected by
Date 3 ^ /-
Building is a: Remarks:
Residence
Multiple � No. 'Units
Coi aercial
Iaduatrial By' Chief Inspector
Inconsideration 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.
B : \.
Please notify the above office when ready for inspection and connection.