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0163.97 Sewer/Water Permit/s
_r, , \ CLAY TOINNSHIP REGIONAL WASTE DISTRICT _ - ..., . , . _ .. FI_NAI�SANITARY'��R RERMIT s� , � .. , INDIVIDUA_L �O��XISTING��D�G4 � _ ,.r: : ' , Project Tillet ��qre�zwoob ��� �' ' w� :<,, . Loc�lion: Il1 �" ,t C�,1�e, ° . ., .;. . . �. . �, .. 1 r.. «,.,.. . � . OwnedBuilde�; �r.1.- �w.e-a - Lol # SS St�eet Ad'd�es's 1\19� �Ruc�le - S(-::: - �;���° . , a Gily: Cwrr�e.\' ,�Zip: �' ._�603L' �,„ .. ' � . ,. � ,� � .— .i:a�..; �. � Ayailability Paid: ' Conneclion Fee Paid: • - .��+�"�•:' J. ,.�e e e Ya'.!•. " • IiilerceptorChargesPaid: Su�charges:' —' � ..;, , . . . . . . . nx ��'� pLE_ASE NOTE;, Installalion of bwlding sewe� shall be pe� the specificalions of the .Clay Towiiship Regional'Waste Dislricl (see reJerse): All installations 'shall be inspected, tiy Dislrict personnel du�ing "open trench" pf�ase end befo�e backfillmg witfi' sand' o� stone to six fnches above the pi�e: N9.�ooting or foundation drains oF othe�souices of ground or storrriwafer, shall • ...r. . . . be permiUed to enterthe Districl's sandary;sewer system The Dislrict will essume no pabilily for dPeins wfiicfi are below the grade level otdFie;near'est downstream manhole�nor fo�late�als wfilcfi . ... - . . .. � w . s.. ,are exteiided benealh d�iveways or sidewalks: The permil holder (property owner; developer o� . builder) will be responsitile: Fordamages to lhe Uistrict s sewe�s system?including,manholes;,, caslirigs,,manhole litls and ihe like, caused py const�uction actiJity on the'timidfng site whicfi is the supject o(lhis permit, tlie permit holde�;is also.;responsible. . #:.��,'. � . . � . , . .� F � .� � Insgections by ihe Dislrici are.,MANDA O ;and shall be arranged by contacimg lhe Districl's of(ice,at 844'-9200'one�to four fiours in advance. All�new construction°will be placed on billing six , monlhs afler connection has been made: ` � • By signing below, F atlest thal I am (amiliar with 4fie DistricCs specifications"and ag�ee=to accepH " responsi6ility tor all work done under,this pe�init, • � ��� . �� Bu'der/O ierSigna 1 / ture: Phone \Ap �� Ins(�ecti'on`Fee.Paid:":$55_00 � �s�te;pla ��mitted , :� �! Permit issued tliis�c�ay of_��1�199�: �' • � CTR�WD � � � �. � � . , � �. a� . a AI ; Uril' • � ' y . �,�'. ' ��� ���S`��° � - Permit valid onl seal in red irik. � ,. tM..17.01.9filtji � � ' � , ' �