HomeMy WebLinkAbout0038.75 Sewer Permit.pdf- CAR MEL .
APPLICATION AND PERIHIT FOR ShWFR SERYICFs'
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' . , STATE . -
PERMIT N0.
Application i� hereby mad for authority to connect tf�e.pr�mt5es at
No. 5%�s�. -,��sp; , lot�� B1oc .�
Additjqn with the city's sewer mai� on Stree�v"���b
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a' inch V.C.P., or C..I.Soil Pipe. Connection will be mad¢
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feet North, South, East, WesL of the manhole:located si: the inte�sec�i�
of :��d ' .
Ask Clerk to'se� Ordinanc� S�3 for'comp�ete spe�ifications. Clay p1pe:
sfia)1 be AST�! C2Q0-45T.. Jolnts shnll be material� having resYller�t
properties ASTM C425-64. Installatfon shall conform to ASTM �peFii�i-
cations C12-64. Np pipe smaller Lhp� stx (6) inches sha:1.1 be;_�sec�,
A11 material and workmanship wilt,be i�j strict complianc� ��th Cif,y
Ordinances re.�axive to such 1�qrk and shall be app�pved by th� S�w�r
Superiptendent before and efRer �a�kf111ingT ;Noncomplia�ce ma�
result ia (q) Digging up and reqpiq� �omple�e installatiot�.
Denial of fut,ure appljcation for �B�
until qrk i5 sdtiifactor,�. Permi�, (�) Denial.of wat�'r �o��FCt1or
L�, � � , rtFF�I} 5 �4 ' �U��M �-1 i �1 C S� � �i �� �
i�-�,c.
CLERK ii R R' H ZED . ,
4 �s +�
To be filled in by;instal�er before backfilling wt11 be_aulhorizeQ.,
P�RMIT NOt��DATE N0. STREET .
LOT BLK.,
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OWNER :
SIZ� OF PIPE = KIND : _
LOGATIG" OF TAP F�ET �,
FROM L I NE OF - ST.. `
DEPTH OF._ MAIN SEWER' ' ��
FT. ENTERS LQT'AT _ �T�tT
FROM L I NE OF - ,,�;ST` '
DEPTH OF= PROPERTII LINE � � � �� � �` ��
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, ,�- ���FT..
PLUMBER ; , _ , ����-
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REFIARKS _ , , ' g ��
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� ��'%.�; � �, CITIf INSPECTQR `�.�������� :�?������r.:� } �
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