4019 Pumice Lane - Tie In Card *= , EAGAN TOWNSRIP
- 3795 Pilot Knob Road
St. Paul, Minnesota 551.1.1.
Telephone 454 -5242
PERHLT FOR WATER SERVICE CONNECTION 4-1-7
D6te• iri Z") - 7
Number: 678
.y i �' 4 c) 'i 'i t 1 1,11 4, n 6, 9'",t,
Si111ng Nama ._ t �� {:� `-•t S ite Address; / i
Owner: ` ... Q . - k it (1 t 1 N : '` Billing Address
a, !�i. 0 1 y l r �
Plumber : �C, t` •v.., A i L t t\,
Location of Connection Metes Size Connection Cbg.300•00 p1 7/3/72 -- • -�-- =—
Meter No. Permit Fee 1O.CO pd 7/3/72
.,.v Pa 7/ 3/72 4/k1 Meter Reading______ Meter Dep.
l Meter Sealed: Yes_ Add'l Chg.
•� NO Total Chg.
Inspected by
Date b 1-1' -7 7-
Euilding is e; mark
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 t o do t proposed Wor in accordance With the rules and
regulati o Eagan Towns D Count Minne sota.
By:, Ciii2(f1, \ !VF. >L (`1 •\ 'lN . ( 1)
l , \,2."3_,1 \ 41-\c, _AZ- 7,',glu\k r ,,..\
Please notify the above office when ready for inspe and connection.
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