Laserfiche WebLink
PLEASANT PRINGS `. <br /> SANITARY D <br /> APPLICATION TO CONNECT A BUILDING SEWER TO PSSD #1 PUBLIC SEWERS <br /> 1. Applicant's Name,Address and Contact Information: <br /> Name: Robert and Ami Kreger <br /> Address: 3372 Storck Rd, McFarland, WI 53558 <br /> Telephone/Fax/E-Mail: 608-206-3752 <br /> CtmeOer e-%ervt',l•Corrt <br /> 2. Applicant's Plumber: <br /> Name: LL tPiurnbin9 and I-iIzti-ec. LLC <br /> Address: 1 to p<,K Si-. , Su<<K Ct+-y , vJz 535£3 <br /> Telephone/Fax/E-Mail: Loch-553-I C7 U-.plurnbir c.c 1elcclric 03ma l .com <br /> 3. Location of Property to be Connected to Public Sewers: <br /> Street Address: ????Yahara Dr. <br /> Tax Parcel No.: 0611-291-0634-8 <br /> Legal Description: Lot 4 <br /> 4. Type of Structure/Building Sewer/Wastewater Discharge <br /> Describe Structure of Building Sewer: Single Family Residence <br /> Wastewater: If the wastewater discharges will be something other than Normal Domestic <br /> Strength Wastewaters(e.g., commercial/industrial discharges), describe the wastewater <br /> characteristics: <br /> N/A <br /> Application fee of$50.00, payable to Pleasant Springs Sanitary District#1, must accompany application. <br /> PSSD must be notified 48 hours prior to connection to the sewer service. You can contact us at 608-873-3074. <br /> Notification of connection is Mandatory. n <br /> D e (fdd 45)e-).5 a+et4" i 5 11 c!,G%89. JL' <br /> Per Chapter 12 of PSSD Ordinance,the Owner of each new user connection shall be assessed a Connection Charge if said charge was <br /> not paid previously. The -20X Conn on ChNe Ns 7,)(0.00 and is set annually with the adoption of the budget. The <br /> Connection Charge shall be invoiced when the Sewer Connection Permit is issued and is due in full no later than the date an Occupancy <br /> Permit is issued for the structure. Sewer Connection Charges not paid by this date shall be subject to interest and penalty charges <br /> under the PSSD Ordinance. Upon acceptance of this application,it shall constitute a contract between PSSD and the applicant,wherein <br /> the applicant agrees to comply with all of the terms and provisions of the PSSD Ordinances, rules and orders in effect from time to <br /> time. / Ci /DZ7 C_rL/dGg <br /> %l `C. r¶, T Amount received: 7bjG) 4), 4/4) <br /> Received from: /L r <br /> Date: /)D/, 02,1 For PSSD: (---- <br /> �Z! �l • L''t. - J4G x1 //o21-01 <br /> 2083 Williams Drive, Stoughton WI 53589-3352 <br /> Phone (608) 873-3074 info@pssd-wi.org Fax(608) 646-0089 <br />