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HomeMy WebLinkAbout0130.97 Sewer/Water Permit/s �,�,�� � �_ � . �i., ' ° „_.� h1 ��ifp�'�14 � �{�. 1 r,•�{�ri°�'9Vy�,�W.�.'%�}�i(1y$ � E`� xS e�ry�cd-�4c1k�d . . ' �h . . �I. 'ME��y i.�� . . � �! � � V�d�.�W� +fn kx>-t4 d � . ' � k V'{L� b ,1 f.. M1 F L rf h#�7Q,�� ���1 �� � J( , . . ' . . . l � r.. � ��a.• ` ! "4.��ty ��{�'��sti Y� ,. ' , t �r. .nt` �! 5 IP�Y:.�.y �A- . . '` � qn��:% ' ' ' �`.���4y ,�j� . CLAY T01NN$HIP�REGIONAL WASTE�UISTRICT9 ,���7 f��•� � � • �NAL SANITARY`SEWER PERMLT� '` ' '�" �-; ',' . � - s�,�°�^l�"�u7', � � ��:", r kl;` ga,� x�` pVD��(JDUA�-� �TS/ XE�ISTING BUILDINqGS � i ° „ ��� . t_i �- T .. i "'� "'�.� � . f-' , C � p (� CT.�Y �AS'1'E WESZ' ' `,, ,a' ,f r!}r�;�� n l�y � , P�oject Tille, < < s u.0�'.•_ :�; ��' �.� - . , „a� ,�`� ' � a ...ii �ini�c/I,CTr( �' :� p `�- . Localion � u ��w ]. �f t „+>„ ' � / �`,` J.X"t' ., � ���� Owngr/Builder' ` " . ' s ` � - ✓'_�Ci , . .. � �_ ,''�n��t,4c 1 r � . L'o_t'# I '�S Street4Address :. � ° � . � - � � ex� „� , E;�,t _ � 64,°I�*�'c.'��'� , �• '- . '� ' .. � `•, � /`- •/e � . • ' , ar r.ii� iip 7� �a� Y'� ��,� f 4� � �,. . . , ., � .�-R .s� d � �.nw : �'�S�i ts�4y���� � '*.. _ . �s + i1'�J�3�i ! S'�y�"'� ; IL''�Y.{w.��'i yn�-� ,� 3 r�' /�.�� . _ Availa6ilit Paid: - � Connection Fee Paid " �`�'� y . . . r dYF,l/ ',r . c ! h a .,� utlz ^FJ�:..�u�� . .. r �� .•�t . ti. � $'� 4 c i�� . 4 � „�•2�d�Lwx�kS'.'?�f.1•�. Interce tor Char es Paid; Surcharges � + p 9. ,F ¢��4�, '/'v � . _,. .� : , •;S ��a 4�m"5�.'�' , .�.,��%'F 9 '��,`����0:'r"��Y'�� �� - � . p�qSE NO1€. In"sfallaLOn of bwldmg"sewe�1shalE be e�the s eGficatwnshof�therCla Y x Y i � .s, _. P, ia,. �u.Por , �.r�».. Township:Regwnal Waste: Distnct (seekreverse) All insl"allatwns�,shallsb�e mspe�ed�by�,Dist�rid personnel during open.trench phase and�bef�ore backfillingNwith sand;o�r stone�toysAx�tncfiees, , " above the p�pe: 1CQ fooUng or (oundation iirains; or otheessources of;,gr�ound orstyorrtiwater sha'll be permdted to�enteralhe',Distnct s�sandary�sewe�isystem' The Dist�rct w{II assu"meano Ilabililyrfor, drains.which a[e tielow the.grade leyel of the�nearest downstream,manhole,no��fo�rk�terdlsbwhich e--. are,extended"beneath driy,eways or:sidewalks�The per'mit,rholder (prope'rtyyown�er�developer or ; bullde�) wlll be responsible: For demeges�,to�the�Distncts sewars,system including ma�nholes;. castings manhole lids and the like,:caused�by�construction acUvi�y,'onathe buildmg�site�rywhich is; the.suti�ect of thisapermit, tlie permit holder�is also re`spunsible ��p��, , .� , . � ���,s���.���� � � ���F i";f �^,a Inspeciions by the Disirict are,M�A_BLQBY and,�shalf be arranged by contac�ing the;DistricCs office a't 844 9200 one�to:four hours:in advancei All�new construction will be placed�On�6il�l��g siz moiitt�s after_connection has been ma`de ali � .L ��,y��t{ {x�• r L� '�� " ��}i:°��at�' } .• ,�r-� . � � 4 . . . 6 i f�t x�lh� +`�, . By signmg below, I attest that I amd(amiliar witfi�the District s specificaUons�a#d�agree�to accepl� responsibilit'for+ I uv done under�-this pe�md � f �;,�e � � `� "k�����" � e Fn � � . 1 ��� r� � c ' ., r �� . � 1�� �I .. ( � �r� _e�L'j � �'Y 4 � � �.� Y il s '� • Builder/Owner Signature',.� � � ° ;� lP,hone ' �rv����C� � � e �f� � c�' a � .,_ '� s���+� em� ����'y�.� � InspectionFeeiPaid: �$�,00 / --��'`�� �e,piao5sun it(� , : �j� ,� � — r ` ,t� �, ��p`� t �� o r�. , ..y � �y Permit issued this o2 tlay of,`. 199;� o � j9�^'i fr �;�r `~-' � � �' � � �����✓�,.r, �.� . � � �.��� e-, � r r u'�.���� � .�q -� , ; � �"'�t '>, 4 ��'�dS�.� �O,'t> . . ° .. , ' .. .i ' .,.y/' :. ' � �'3'Y `M1-d'-dr �, JayW. A{ley;,Utility Manager ` ' � ' � �� � J°'�°�'��'�'� , 6 y � . . , � �,� ; � � HIp;REG10S��'�'�^.�,� - � .. F;w.� �i ��. , .v �r .- <w���, . � ' " ' Permit valid,only wdh CTRWD seafFn�red ink:. . ; . w # ��� ���. , „f �,.t��Y v. � ��>�w� � � fN 11-:01 B&CjI � �[j� //�,� ����y�'Si l �%� � �� Y� 1�: d.//� [ -���/(/�� /�r` � ,�' � � i�� 1 IA � I . �J O i'�/f /l//V�� I ' ,. t � _ .Y�x��t t.�a / ��'` l/� ���� //�' J ,U . . . � �� � � .�) �Y ��� ���� dk ° �;� •ly.,' W �1 '* , ,� /� `�/ � � � ���j � ��erl�„�W������ {����S�y-45���f h'a�'S.'�! ��4� ���7�x�'�A S:i��c . � ���6i76�`_ _ . . . � - ' . ry � •m,aa.v ��. "� ,W�� 9 .nx . ""} • � ����� _ ' i�F `� a a.z.R1;•�"- .'": r�V�..,... .`S,_�'�R�_.1�