1709 Monticello Ave - Tie In Card EAGAN TOWNSHIP
A t ' 3795 Pilot Knob Road
St Paul Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date: i ' r( �-NN umber: 965
Billing Name, \ e V
r " f)k) ( . ` )f" Site Address: / 7C/ ''' t 1 17 f i i,)
Owner: C-* 1 1 ' ' I Billing Address/ - 4I' \ '17C( f`
Plumber: 15 -tF'I i� , li 1�7. ),riq . St .' �u1 i- Ln. - '
l i
Location of Connection Meter Size Connection Chg. 300.00 pd 0/29/72
....." . ' '''''''''....-...'j
L"---\ Meter No. Permit Fee 10.00 pd 8/29/72
.50 pd U/29/72 sic
Meter Reading.„_ Meter Dep.
if Meter Sealed: Yea Add'1 Chg.
y ? 1 — NO Total Chg.
Inspected by
Date / e • Il' 7 '...'l
Building is a: Remarks:
Residence
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 County, Minnesota.
By:
Please notify the above office when ready for inspection and connection.