4025 Pumice Lane - Tie In Card ,' EAGAN TOWNSHIP
3795 Pilot Knob Road
$t. Paul, Minnesota 55111.
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION 3.1 .-7
Date: r; .4-. Number: 580
Si111 .
n$, Name :\ ci A t t'N).%' 1./. *,:Site Address: Lt' 1 ��t t 1 111 t 't - ,
Owner: \,. (',CNI`f t a. )4 tt " - , Billing Address I "v ` \ 1'1� t 1
} yy r
Plumber:' `" r 1 N 1 l 1 Y1 S' fl )4 ' Iv + va' 1 i ? ►� L It 1 s , _t
Location of Connection Metes Size
Connection C . 300.0'3 Td 7/3/7
Permit Fee 10.00 pi 7/3!72
Meter No. _ .2u L.' ii 3 /72
Meter Reading Meter Dep.
Meter Sealed: Yea_ Add'l Chg.
Total Chg
3 7 % .3
Inspected by
Date 7.. 2» - 7 '
Building, is a: Remarks:
Residenc
Multiple No. Unite
Commercial
Industrial 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, Minn ta. (
By:. , x t' : i1 \ ! 11 ,....1 E'*.l4' l Z , { ( t
„ �'�
t \ °'t 1 - \y/7 l l'
Please notify the above office when ready for inspection and connection.
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