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• <br /> CONTRACT <br /> SEWER CONNECTION APPLICATION <br /> WINDSOR SANITARY DISTRICT NO. 1 <br /> Application No. 57 j Date '-J? -O 9 <br /> V€C y c.i q (N hereby makes application for sewer service at the <br /> (Owner) <br /> following location: <br /> Address e rn 6 Ca n d}- izd Lot )5.7 Black <br /> Parce>:r 9o. Addition ] n U n i f i d E <br /> 7`ypef"Building: —Single Family Multi-unit dwelling <br /> Commercial Industrial <br /> Kind of Service: (.-New Replacement Improvement <br /> Size of Connection: y rr Type of Material i V C <br /> Name and address of firm doing the proposed work: -"Do, e -61 n e <br /> Mc\(11' 5onr ( � T_. <br /> The customer is responsible for the cost of material and installation from the <br /> sewer main to the structure. If a road crossing is necessary, trenchs in paved <br /> streets shall be refilled with compacted sand or gravel. There will be 6" deep <br /> concrete bridging placed over the excavation and 2" bituminus mixture (hot mix) <br /> placed over the concrete 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 ordinances <br /> of the Madison Metropolitian Sewerage District and the Windsor <br /> Sanitary District No. 1 and all other pertinent ordinances or <br /> regulations that may be adopted in the future. <br /> 2. To maintain the building sewer at no expense to Windsor Sanitary <br /> District No. 1. <br /> 3. To notify the Town of Windsor plumbing inspector when the building <br /> sewer is completed and ready for inspection, but before any portion <br /> of the work is covered. <br /> REMARKS: <br /> • <br /> Date g - loZ -8 ,1 - <br /> Signe' <br /> `app icant <br /> $ Cn(O.°Hookup fees paid. <br /> Application approved: address of applicant- <br /> Date 7? ° • Qy <br /> (phone) <br /> rup' e `^' , c er , e c.) <br /> CONDITIONS: <br />