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APPI-1CATION AND 11,RMI T FOR SEWER SERVICE
J
PERMIT NO. �2� f 'j 27
App lica ion is hereby mad for authority to connect theremi
No f
-L Street,
Addition wit the city's sewer main
p ses a
Ave.. Lot,22Y Block
on
S t r e e t, Ave. by
a inch Y.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
shall be ASTM C200 -65T. Joints shall be materials havingresilie pipe
properties ASTM 0425-64. Installation shall conform to STM specifi-
cations C12-64. No pipe smaller than
Six (6) inches shall be used.
All material and workmanship will be in strict compliance with
Ordinances relative to such work and shall be a City
Superintendent before and after backfilling. Noncompliance m Sewer
res in (A) Digging up and redoing complete installation, may
De(iia of future application for permity., }
un it ork is satisf (C) Denial of water connection
CLERK'
TO a filled in by installer before
PERMIT NO. --DATE NO.
LOT BLK.,�—
OWNER
udcKT>>)ing will be authorized.
SIZE OF PIPE -----
IPE--------------- -KIND
LOCATION OF TAP
-
FROM LINE OF FEET
DEPTh OF MAIN SEWERST.
FT. ENTERS LOT AT
FROM FT.
LINE OF
DEPTH OF PROPERTY LINE ST.
PLUMBER FT.
STREET
REMARKS
116 /—, k/
CITY INSPECTOR
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