HomeMy WebLinkAbout0873.99 Sewer/Water Permit/sCLAY TOWNSHIP REGIONAL WASTE DISTRICT
SANITARY SEWER PERMIT
] Conditional Permit [ ] Final Permit
INDNIDUAL LOTWEXISTING BUILDINGS
Project Tide: Cl,[1kT WAS 1 L
Location:
Lot # Street address
U12
City: 2 Zip: V&
Availability Paid:
().
Connection Fee Paid: ?to
Interceptor Charges Paid: v--- Surcharges: -- LOC
PLEASE NOTE: Installation of building sewer shall be per the specifications of the Clay
Township Regional Waste District (see reverse) and any conditions noted below. All installations shall be
inspected by District personnel during "open trench" phase and before backfilling with sand or stone to six
inches above the pipe. NO footing or foundation drains, or other sources of ground or stormwater, shall be
permitted to enter the District's sanitary sewer system. The District will assume no liability for drains which are
below the grade level of the nearest downstream manhole nor for laterals which are extended beneath
driveways or sidewalks. The permit holder (property owner, developer or builder) will be responsible. For
damages to the District's sewers system including manholes, castings, manhole lids and the like, caused by
construction activity on the building site which is the subject of this permit, the permit holder is also responsible.
Inspections by the District are MANDATORY and shall be arranged by contacting the District's office at 844-
9200 one to four hours in advance. All new construction will be placed on billing six months after connection
has been made.
By signing below, I attest that I am familiar with the Districts specifications and agree to accept responsibility
Uaf worts done under this permit.
i
District will inspect all sump pump connections 30 to 60 days after the lateral inspection has
been completed.
Conditional Permit Terms:
[ ] NO CONNECTION to the sewer until further notification.
[ j Certificate of Insurance must be on file with CTRWD listed as certificate holder.
[ ] 48 hours notice before work starts on manhole core drilling or cuts of active lines
and District inspector must be on site.
[ ] All District fees will be paid in full.
[ ] Approval pending Districts review of plans.
[ ] Copies of approved permits from appropriate county or city agencies for work in
right-of y
r ' t
?
AII, onditions hav been met and
der/Ovmer Si
Inspection Fee Paid: $55.00
Permit issued M92-? day of
or
final permit issued' 19_
Phone
2 srte plans submitted
199.
IA?
162
TW. Alley, Utility Manager
c?
GIOD i
Pan*- v.2-9WCjf Permit valid only with CTRWD seal in red ink.