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I <br /> I <br /> Sewer Connection Application <br /> W'indsoir Sanitary District#1 <br /> Application No. 7 <br /> Date: <br /> Cat Cdr, r 4' (' hereby makes application for sewer service at the following location: <br /> (Owner <br /> Address: I ell t r + Lot: Block: .�iit <br /> Parcel No. Addition ,; 'r fC (,l <br /> Type of Building: Single Family multi-unit dwelling Commercial lndusfriat <br /> I <br /> Kind of Service: New Replacement 1mptovement <br /> Size of Connection: ;r Type of Material 'Iv <br /> Name and address of from doing the proposed work: L, is r It1�, :, � •• <br /> L . <br /> customer is responsible for the cost of material and installation from the, sewer main to the structure. if ba mad <br /> crossing is necessary,trenches in paved streets,shall be refilled.with comp i"cieo:'sand or gravel There will be& <br /> deep concrete bridging placed over the.excavation and 2"bituminous.mixture(hot mix)placed over th e concrete <br /> to.match street grade. , <br /> Remarks: <br /> In consideration of the granting of this permit the undersigned agrees: <br /> 1. To accept and abide by all provisions of the sewer use ordina Ices:of the Madison Metropolitan' <br /> Sewerage District and the Windsor Sanitary District#1 and=al other pertinent ordinances or <br /> regulation that may be adopted in the future. <br /> 2 To maintain the building:sewer at no expense to Windsor San nary District##1 <br /> 3' To notify the Town of Windsor Plumbing Inspector when the building sewer is completed and <br /> ready for inspection,but before any portion of the work is covered. <br /> 4. To install tracer wire and grounding rod,_,in,accordance with,d SD#1 ordinance. <br /> Remarks: <br /> Date: i W S°, _f Signed <br /> (ap. ,;;:nt <br /> $ .Q) Hookup fees paid. <br /> (address of applicant) <br /> { u rintendent,clerk.etc.); (phone) <br /> CONDITIONS: <br />