3924 Palisade Way - Tie In Card
EACAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date: ( ( Number: 1019
Billing Name~_'t•. ~•LC~\ fSite Address:
Owner: Billing Address kWa, 4
Plumber: ~i Y (1 Y1 G 1~
Location of Connection Meter Size Connection Chg. F -70/2
L Meter No. Permit Fee 10.00 0 .10/2.15/7
/z5/7
Meter Reading _ Meter Dep. ,
Meter Sealed: Yea Add'1,Chg.
d y NO Total Chg.
7 Inspected by
Date !f- ~3 '7 'tom
Building is a: Remarks:
Residenc-L _
Multiple No. Units
Commercial
Industrial By:
Chief Inspector
Other
In conaideration 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 1
Plesso notify the above office when ready for inspection and connection.