6155 Deer Ridge7
SEWER, WATER OR(��imON SZRVIC-v FORM (CM-RCLZ ONE)
Mun -ic ipal i t", CHANHASSEN Service 210.
trrY PROJ/ M. Sheet No.
House No.
Lot 3 Block Par=el No.
Deer
Wffirlw
Dc-,:nszream Man.-cle No. z '2+37
Sta. at ?.' Downstream Manhole
Ejavaticn at c.:.. of sewer Main
.Zor rc�ndamicn Elevation De;t� or Basement
Denz� C.j C:ean-cut Clean -Out -
Distance frcm Sewer Main tz Clear, -cut
0: Grade fc: Service to be instal__1-
(if i..ini gra-de service) rr
L.enaz: , size and type of service pipe
Depth at ?- 1014.0
DC;Wnst=ea= Manho No. 'Z
Sta. at P.L. f=== Dcwnst=aam Manhole
-
Len;zn, s--*T-e and type of service pipe
*I Dsczh at P-L.
Denctas sewer service end
Denotes water service end
Tiecl by P R—
. 1.01
Foreman re c,
Date
Locat-;cn and depth of services certified by
Date
NOTE: Service: tics shall be swing ties to pc. structures such as building
comers, valve boxes, manholes,, catch basins, hydrants, etc- Ties to trees,
power-poles, property comers, telephone or utility boxes will not be accepted.
A
40 CITY OF
S I 'IV ALNDARD
=� G = ��iSSE TIE CARD
kREVtSZED 2-93 DATE PLATE: NO.
2 5221
- 14-93