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City of Lakeville �
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Sevver and �lilater Tie Card
Address � �,5,��� ��-�� c; ( �,�:��
Contractor �s r''� �XC_,
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Permit Number_ 1�,� 3;
Date 13 - l-'����'
Street Drain-tile `���
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Size of Water Service
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` Comments I Q-TE 1Tf�(� V�12- 7.D' � ��Tr�NG�S
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f�ust have �hi� ca�c� or� si�e for �he ir�spector at the f6me
of the ins�ec#��n. "
20195 Holyoke Avenue,Lakeville,MN 55044
952-985-4400•952-985-4499 fax g
www.lakevillemn.gov r