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Sewer & Water Tie Card �
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Address: $112 182nd St
Contractor: �� ' '� '
Permit Number•
Final Date•
Street Drain-Tile: Yes
Size of Water Service: 1"
Comments: AIRTEST SANITARY OVER 20'/2 FITTINGS
THIS CARD MUST BE COMPLETED AND ON-SITE AT TIME
OF SEWER &WATER INSPECTION
20195 F�ol}'oke Avenue,Lake��ille,MI�55044
952-985-4400•952-985-4499fax
ww�v.l akevilleinn.gov