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:' . e Spy - 0 —tisi c-i <br /> CONTRACT <br /> SEWER CONNECTION APPLICATION <br /> WINDSOR SANITARY DISTRICT NO. 1 <br /> Application No` . j3 7 Date W-!() -09 <br /> e (itl10 r 4n m r5 hereby makes application for sewer service at the <br /> (Owner <br /> following location: <br /> Address S j n 9-e s lA)c-\/ Lot,/13 Sleek <br /> Parcel No. Addition 140 110;„-A cl j p S <br /> Type of Building: X Single Family Multi-unit dwelling <br /> Commercial Industrial <br /> Kind of Service: -'C New Replacement Improvement <br /> Size of Connection: 1 ii Type of Material 17 V C <br /> Name and address of firm doing the proposed work: `Da J e -3-a n eS <br /> r <br /> V \ociSOr , tJL <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 /> Date (a - I C.) -f)9 Signed <br /> k i►',,.rr��.i a., <br /> app ant' <br /> $(,ja),cp Hookup fees paid. J , ,�, e <br /> Application approved: ad ress o app icant /1,�age, <br /> CPO. 9 /o -�/a-o �37r3 <br /> Date � - � At / - <br /> phone <br /> au.1= ° en.ent, c er , e c.) <br /> CONDITIONS: <br /> • <br /> • <br /> f <br />