HomeMy WebLinkAboutSewer ApplicationAPPLICATION AND 11ERMIT FOR SLI ER SERVICE
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CITY STATE
PER144T NO.f�71// +f- J�--c/ :;Z-�
Application is hereby made for authority to connect the premises at
No. �3 � J, IJ�S-reet, Ave-,, Lot 3s" B1ock'k�/�
"-2"4
Addition with the city's sewer main on____ Street, Ave., by
ainch V.C.P., or C.I.Soil Pipe. Connection will be made
feet North, South, East, West of the manhole located at the intersection
of and
Ask Clerk to see Ordinance S-3 for complete specifications. Clay pipe
shall be ASTM 0200-p5T. Joints shall be materials having resilient
properties ASTM C425-64. Installation shall conform to ASTM specifi-
cations C12-64. No pipe smaller than six (6) inches shall be used.
All material and workmanship will be in strict compliance with Pity
Ordinances relative to such work and shall be approved by the Sewer
Superintendent before and after backfilling. Noncompliance ma
result in (A) Digging up and redoing complete installation, (BI
Denial of future application for permit, (Cl Denial of water connection
until vi rk is satisfactory.
/--ER 0 NEOR AUTHORIZED PLUMBER
To Lich filled in by installer before backfilling will be authorized,
PERMIT NO. DATE NO. STREET
LOT BLK. ADD.
OWNER ` „GAJ 0. 0)- -
SIZE
) -SIZE OF PIPE KIND
LOCATION OF TAP FEET
FROM LINE OF ST.
DEPTH OF MAIN SEWER_ _FT. ENTERS LOT AT FT.
FROM LINE OF ST.
DEPTH OF PROPERTY LINE FT.
PLUMBER
REMARKS
a3/'� a� CITY INSPECTOR