3871 Palisade Way - Tie In Card
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PEIUaT FOR WATER SERVICE CONNECTION
Date: 3/28/73_(12/29P Number: - 111,6,
Billing Name:owjnr Orove Qm3trvotion Co$ite Address: ;821 r.j&4j4A V4q
Owner . 9 Billing Address-
Plumber:- Stein I e
Location of Connect on Meter Size Connection chg 3/26/73
Meter No. Permit Fee 10.00 Pd 12/29/72
q Meter Reading Meter Dep. 12/29/72
Meter Sealed: Yea_ Add'1 Chg. ND Total Chg. ,
Inspected by
Date
Building is a: Remarks:
xx
Residence
Multiple No. Units JIB iii I,,L U "itJE
Commercial
r
Industrial By:
Chief Inspector
Other
In consideration of the issue and delivery tome of the above permit, I-
hereby agree to do the"proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
By:
3Lein~e
Please notify the above office when ready for inspection and connection.