3882 Palisade Way - Tie In Card r 4~
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EAGAN TOWNSHIP
3195 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date: Number:1OB1T~~
Billing Na 15 bite Addreas. ~ v
Owner, Billing Addreea t>~~
Plumber: l
Location of Connection Meter Size Connection Ch9.a[xt_0_O x12/1
Meter No. Permit 'FeeIn-nn r19,Ti1/►2
Meter Reading Meter Dep. " 50 11/72 8
Meter Sealed: Yes- Addll Chg.
~J y NO Total Chg.
'1 0 Inspected by
Date 4 All' >1
Building is a: Remarks:
Resideuca~_
Multiple No. units
Commercial
Industrial By:
Chief inspector
Other
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota Counyty,~~ Minnea t ,
a..
BY
Please notify the above office when ready for impaction and connection.