HomeMy WebLinkAbout780417 Sewer PermitWN-MMVAN
AI'I'LICATIO\ A\D I'ERIMIT FOR SEDER SERVICE
PERMIT NO.�a ,
Application is hereby made for authority to connect the premises att
too.�i __Street, Ave., Lot_ Block%
t."6-4,
Addition with the city's sewer main on
Street, Ave., by
a inch Y.C.P., or C.I.Soil Pipe. Connection will be made______
eet 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 C200 -65T. 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 City
Ordinances relative to such work and shall be approved by the Sewer
Superintendent before and after backfilling. Noncompliance may
result in (A) Digging up and redoing complete installation, (B)
Denial of future application for permit, (C) Denial of w er connectior
until is satisfactory.
CL .
p UTN IZ D PLUMBER
To be filled in by installer before backfilling will be authorized.
PERMI� _ 1 Vn
LOT
OWNER
STREET
SIZE Of PIPE KIND
LOCATION OF TAP
FROM LINE OF
FEET
ST.
DEPTH Of MAIN SEWER FT. ENTERS LOT AT FT.
FROM LINE Of ST.
DEPTH Of PROPERTY LINE
PLUMBER
REMARKS
CITY INSPECTOR _.
FT .
AGREE14ENT
The builder accepts this permit with the knowledge that
the sanitary facilities are at or near capacity. In the event
the State Board of Health or any other governmental agency
orders a building moratorium in Carmel or Clay Township, or
causes the City of Carmel to declare a moratorium because of
this sewer problem, the undersigned builder agrees to hold
harmless the City of Carmel and/or its officials from any and
all costs, expenses, Judgments and attorney fees resulting
from such moratorium.
rRA1.
WITNESS:
DATED U " / % — 7-P
11
WITNESS:
DATED U " / % — 7-P
11