3916 Palisade Way - Tie In Card - °' EACAN TOWNSH
3795 Pilot Knob Road
St. Paul, Minnesota 551.11
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Dare: I r:).1 1■), a
Number: 1090
Billing , N eale ' ;��(c'l5 . ( -'t 1`O )P QJS�1 Site Owner; Addrese:. ( "l (t) fk.,Fc.i K'�C`
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,, • Billing Addreee 1 f ;( rr\ ` }
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P lumber: r1 Y\
Location of Connection Meter Size Connection Chg.100.()() , %d 12113
Meter No. Permit Fee 10.00 r d l? /1 13/72
.50 14 a/c
• Meter Reading Meter Dep.
g9 . L Meter Sealed: Yea_ Add'l Chg.`_.
7
Total Chg.
, . , . , Inspected by
. .. , ... Date / V,y , 3
Building is a: Remarks:
Residence xx .
Multiple No. Unita Alr ^ r, IN EC,' �''' 77E 1
Commercial LM P 3.l.l.i.':lil IALL�l) Ia'aiLIiJ.
Industrial` By: Chief Inspector
Other
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 C ugty, .- -,� A
By , (> \ 1 At a1.`r \ N \ .}
Please notify the above office when ready for'inapection and connection.