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Sewer onnection Application <br /> Wind or Sanitary District#1 <br /> Application No. 5384 Date: July 15,2015 <br /> Veridian Homes AB, LLC hereby akes application for sewer service at the following location: <br /> (Owner) <br /> Address: Royal Artis Rd Lot: 267 Block: --- <br /> Parcel No. -- Addition: Holland Fields <br /> Type of Building: K Single Family Multi-unit dwelling Commercial Industrial <br /> Kind of Service: K New Replacement Improvement <br /> Size of Connection: 4" Type •f Material PVC <br /> Name and address of firm doing the propos- work: Dave Jones Plumbing <br /> Madison WI <br /> The customer is responsible for the cost of ma :vial and installation from the sewer main to the structure. If a road <br /> crossing is necessary,trenches in paved stree, shall be refilled with compacted sand or gravel.There will be 6" <br /> deep concrete bridging placed over the excay. ion and 2"bituminous mixture(hot mix)placed over the concrete <br /> to match street grade. <br /> Remarks: <br /> In consideration of the granting of this permit t e undersigned agrees: <br /> 1. To accept and abide by all pro isions of the sewer use ordinances of the Madison Metropolitan <br /> Sewerage District and the Win•sor Sanitary District#1 and all other pertinent ordinances or <br /> regulation that may be adopt-i in the future. <br /> 2. To maintain the building sewe at no expense to Windsor Sanitary District#1 <br /> 3. To notify the Town of Windsor i'lumbing Inspector when the building sewer is completed and <br /> ready for inspection,but befor any portion of the work is covered. <br /> 4. To install tracer wire and grou ding rod in accordance with WSD#1 ordinance. <br /> Remarks: <br /> VL 'u.� `G1.r�1 ��V'YI,�C LL L <br /> Date: July 15,2015 Sign <br /> (applica <br /> (e I lit: \to tt N t ' <br /> OO.O �+° �� l��'�� S 3�1 13 <br /> $�o OMookup fees paid. V <br /> (address of applicant) <br /> ( erintendent,clerk,etc.) (phone) <br /> CONDITIONS: <br />