UTILITY MAIN EXTENSION CONTRACT
AGREEMENT made and entered into this ________ day of __________________, by and between the Utility System of the City of Johnston City, Illinois, hereinafter called the “Utility Department” and______________________________, hereinafter called the “Depositor”.
FIRST: That the Utility Department contracts and agrees to have installed by contract in accordance with its rules, utility mains as shown on the plat thereof, and the specifications are attached hereto and made a part hereof.
SECOND: Bids having been taken and the lowest responsible bid having been in the amount of $______, the Depositor agrees to deposit and does deposit herewith the cost thereof.
(A) The lowest responsible bid $________.
(B) Engineering and Inspection Charge $_________.
(C) TOTAL: $________________.
THIRD: Final costs to be adjusted up or down according to completed job cost.
FOURTH: The ownership of the utility mains laid herein shall be at all times in the Utility Department, its successors and assigns.
FIFTH: This Agreement shall be valid and binding on the Utility Department only when signed by the Mayor and Clerk.
SIXTH: This Agreement shall be binding upon the heirs, executors, administrators, successors or assigns of the respective parties.
EXECUTED in duplicate by the parties hereto on the date first above written.
UTILITY DEPARTMENT
CITY OF JOHNSTON CITY, ILLINOIS
BY: ___________________________
MAYOR
ATTEST:
______________________________ _____________________________
CITY CLERK APPLICANT/DEPOSITOR
WITNESSES:
_________________________________
_________________________________
RESIDENTIAL OR COMMERCIAL BUILDING SEWER APPLICATION
The undersigned, being the _____________(owner, owner’s agent)___________ of the property located at _______(Number) (Street)__________ does hereby request a permit to install and connect a building sewer to serve the ___________(residence, commercial building, etc.)________________ at said location.
1. The following indicated fixtures will be connected to the proposed building sewer:
NUMBER FIXTURE NUMBER FIXTURE
________ Kitchen Sinks ________ Water Closets
________ Lavatories ________ Bathtubs
________ Laundry Tub ________ Showers
________ Urinals ________ Garbage Grinders
Specify Other Fixtures: ________________________________________
2. The maximum number of persons who will use the above fixtures is ________.
3. The name and address of the person or firm who will perform the proposed work is _____________
______________________________________________________________________.
4. Plans and specifications for the proposed building sewer are attached hereunto as Exhibit “A”.
IN CONSIDERATION OF THE GRANTING OF THIS PERMIT, THE UNDERSIGNED AGREES:
1. To accept and abide by all provisions of the City Code, and of all other pertinent ordinances and codes that may be adopted in the future.
2. To maintain the building sewer at no expense to the City.
3. To notify the City when the building sewer is ready for inspection and connection to the public sewer, but before any portion of the work is covered.
DATE: _________, 20____ SIGNED: ________________________
(APPLICANT)
_____________________________________
(ADDRESS OF APPLICANT)
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(CERTIFICATION BY CITY TREASURER)
$________ (Inspection Fee Paid) DATE:________, 20_____
$________ (Connection Fee Paid) SIGNED:________________________________
(CITY TREASURER)
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(APPLICATION APPROVED AND PERMIT ISSUED)
DATE: _________, 20____ SIGNED:_________________________
(CITY CLERK)
INDUSTRIAL SEWER CONNECTION APPLICATION
The undersigned, being the ____________(owner, owner’s agent)___________________of the property located at ___________(Number)___(Street) _____________________ does hereby request a permit to ____(install, use)_________ an industrial sewer connection serving the _____________, which company is engaged in ___________________________________ at said location.
1. A plan of the property showing accurately all sewers and drains now existing is attached hereunto as Exhibit “A”.
2. Plans and specifications covering any work proposed to be performed under this permit is attached hereunto as Exhibit “B”.
3. A complete schedule of all process waters and industrial wastes produced or expected to be produced at said property, including a description of the character of each waste, the daily volume and maximum rates of discharge and representative analyses is attached hereunto as Exhibit “C”.
4. The name and address of the person or firm who will perform the work covered by this permit is ____
______________________________________________________________________.
IN CONSIDERATION OF THE GRANTING OF THIS PERMIT, THE UNDERSIGNED AGREES:
1. To furnish any additional information relating to the installation or use of the industrial sewer for which this permit is sought as may be requested by the City.
2. To accept and abide by all provisions of the City Code, and of all other pertinent ordinances or codes that may be adopted in the future.
3. To operate and maintain a control manhole and any waste pretreatment facilities, as may be required as a condition of the acceptance into the public sewer of the industrial wastes involved in an efficient manner at all times, and at no expense to the City.
4. To cooperate at all times with the City and its representative(s) in their inspecting, sampling, and study of the industrial wastes, and any facilities provided for pretreatment.
5. To notify the City immediately in the event of any accident, negligence, or other occurrence that occasions discharge to the public sewers of any wastes or process waters not covered by this permit
DATE: _____________, 20_____ SIGNED:_______________________
(APPLICANT)
___________________________________
(ADDRESS OF APPLICANT)
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(CERTIFICATION BY CITY TREASURER)
$_________ (Inspection Fee Paid) DATE: __________________, 20______.
$_________ (Connection Fee Paid) SIGNED:___________________________
(CITY TREASURER)
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(APPLICATION APPROVED AND PERMIT ISSUED)
DATE: _____________, 20_____ SIGNED: ______________________
(CITY CLERK)
APPLICATION FOR SANITARY SEWER SERVICE CONNECTION
The undersigned, representing himself as owner of the property located at ___________________
_________________________________, hereby makes application for Sanitary Sewerage Service for said property, and in consideration of the furnishing of said service covenants and agrees as follows:
1. I agree to abide by all rules and regulations as specified in and by the ordinances of the City now in effect or ordinances enacted and passed from time to time providing for the regulation of the sanitary sewer system or specifying fees and rates to be charged for connection and sanitary sewer service furnished by the City. It is further acknowledged and agreed that the undersigned, his heirs, executors, administrators, successors and assigns shall pay all charges for connection fees and sewer usage which shall become due as the result of the connecting of the sewerage mains and the furnishing of sanitary sewerage service to the above property, and that all such charges and fees for sanitary sewerage service rendered to the property, together with penalties, if any, and the costs of collection are to be considered and become a charge against the property, the lien so created to be enforced in accordance with the ordinances of the City.
2. All bills for the aforesaid charges are payable within ten (10) days following the receipt of said bill and if not paid, are subject to a ten percent (10%) penalty.
3. Each and all of the agreements and covenants herein contained shall run with the real estate above described whose present owner is signatory to this application.
4. I understand that after making this application, I am to await installation permit and instructions therewith.
5. SERVICE CONNECTION FEE: $______ is enclosed herewith, payable to the City.
6. Permission is hereby granted to the City and its authorized representatives at any reasonable time to enter the premises of the applicant and any portion thereof for the purposes of inspecting all connections appurtenant to the sewerage outlets, pipes and mains.
__________________________ ________________________________________________
(APPLICANT’S SIGNATURE) (STREET NUMBER AND NAME OF STREET)
__________________________________________ ___________________________________
(OWNER’S SIGNATURE, IF NOT APPLICANT) (CITY, STATE AND ZIP CODE)
___________________________________
(TELEPHONE NUMBER) (DATE)
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(
MAIL BILLS TO: (____________________________________
(NAME)
MAIL BILLS TO: (____________________________________
(NAME)
Do not fill in the
spaces to the right (_________________________________________
if the information (STREET NUMBER AND NAME OF STREET)
is the same as the (_________________________________________
applicant above. (_________________________________________
(CITY, STATE AND ZIP CODE)
spaces to the right (_________________________________________
if the information (STREET NUMBER AND NAME OF STREET)
is the same as the (_________________________________________
applicant above. (_________________________________________
(CITY, STATE AND ZIP CODE)
RECEIPT
Receipt is hereby acknowledged of the executed Application for Sanitary Sewer Service Connection from the person and for the property indicated below.
This receipt does not authorize service connection is made, inspection and approval of the customer service line by an authorized representative of the City is required, and approval of such connection and issuance of a Certificate of Inspection and Approval and Permit is conditioned upon compliance with all the Ordinances, Codes, Rules and Regulations of the City.
NOTE:
1. In the event the location of the sewer service connection is unknown, the Superintendent is to be contacted.
2. This office is to be notified the day before the work is to be done so that inspection may be arranged in accordance with specifications furnished. For example, if you desire inspection on Tuesday, contact us on Monday. If you desire inspection on Monday, contact us on Friday, etc.
3. If the sewer line is deep enough to drain your basement, if you have one, then the wastes from the basement as well as the other floor(s) of the property must go into the sanitary sewers. Downspout and surface drainage are prohibited inasmuch as this is not a storm sewer system.
WARNING! In order to coordinate our inspections, we must be advised a day in advance before the work is done. The inspection must be made before the trench is backfilled. If trench is backfilled before the inspection is made, it will have to be reopened to permit inspection.
NO. _____________________ CITY OF JOHNSTON CITY
DATE: _____________________ COUNTY OF WILLIAMSON
ADDRESS: __________________
OWNER(S): _________________
_____________________________
CERTIFICATE OF INSPECTION, APPROVAL AND PERMIT
IT IS HEREBY CERTIFIED THAT inspection has been made of the individually-owned sewer mains and sanitary service connection for the property described below, and said installation is hereby approved as in compliance with the Specifications, Rules and Regulations established by the Revised Code (Chapters 51 through 55) of this Municipality.
Permission is hereby granted to complete the construction of said individually-owned sewer main to the City Sanitary Sewerage System and to utilize the same for waste disposal in compliance at all times, with the Revised Code of this City.
NO. _____________________________
ADDRESS: __________________________________________________________________
TYPE OF CONNECTION:
____________ Single-Family Residence
____________ Multiple dwelling or trailer court
____________ Commercial
____________ Industrial
____________ Institutional
____________ Governmental
INSTALLATION BY: __________________________________________
THE SERVICE IS IN OPERATION AS OF THIS _____ DAY OF _______________, 20___.
CITY OF JOHNSTON CITY
COUNTY OF WILLIAMSON
SIGNED: ___________________________
APPLICATION FOR WATER SYSTEM SERVICE CONNECTION
The undersigned, representing himself as owner of the property located at ___________________
________________________ hereby makes application for connection to the Water System of the City for said property, and in consideration of the furnishing of said service covenants and agrees as follows:
1. I agree to abide by all rules and regulations as specified in and by the ordinances of the City now in effect or enacted and passed from time to time providing for the regulation of service furnished by the City, it is further acknowledged and agreed that the undersigned, his heirs, executors, administrators, successors and assigns shall pay all charges for connection fees and water usage which shall become due as the result of the connecting of the water mains and the furnishing of water service to the above property, and that all such charges and fees for water service rendered to the property, together with penalties, if any, and the costs of collection are to be considered and become a charge against the property, the lien so created to be enforced in accordance with the ordinances of the City.
2. All bills for the aforesaid charges are payable within fifteen (15) days following the receipt of said bill and if not paid, are subject to a ten percent (10%) penalty.
3. Each and all of the agreements and covenants herein contained shall run with the real estate above described whose present owner is signatory to this application.
4. I understand that after making this application, I am to await installation permit and instructions therewith.
5. SERVICE CONNECTION FEE: $__________is enclosed herewith, payable to the City.
6. Permission is hereby granted to the City and its authorized representatives at any reasonable time to enter the premises of the applicant and any portion thereof for the purposes of inspecting all connections appurtenant to the Water System.
CONNECTION MUST BE INSPECTED BEFORE BACKFILLING:
SIGNATURE: ____________________ _______________________________________
____________________________________________________________
(STREET NUMBER AND NAME OF STREET)
____________________________________________________________
(CITY, STATE AND ZIP CODE)
____________________________________________________________
(TELEPHONE NUMBER) (DATE)
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Do not fill in the (__________________________________
spaces to the right (__________________________________
if the information (NAME)
is the same as the MAIL BILLS TO: (__________________________________
applicant above. (STREET NUMBER AND NAME OF STREET)
(__________________________________
(__________________________________
(CITY, STATE AND ZIP CODE)
UTILITY SHUTOFF HEARING NOTICE
This notice is being sent to you pursuant to the provisions of CHAPTERS 51 through 55 OF THE REVISED CODE OF ORDINANCES as adopted by the corporate authorities.
CUSTOMER’S NAME:___________________________
ADDRESS: _________________________________________________________________________
TOTAL AMOUNT OF BILL: $________ WATER
$_________ SEWER
$_________ OTHER
SUB-TOTAL: $_________
PENALTY: $_________
TOTAL DUE: $_________
DATE OF HEARING ____________________
TIME OF HEARING ____________________
LOCATION OF HEARING ____________________________________________________________
___________________________________________
PHONE: ____________________
If the consumer/customer fails to appear at the hearing, the applicable utility services shall be terminated [shut off] without further proceedings.
If payment for the charges and fees is received prior to the date of the hearing, you may disregard this hearing notice.
The Mayor and City Clerk, or their designated representative(s), shall preside at the hearing.
__________________________________
CITY CLERK
DATED THIS ______ DAY OF_______________, 20______.
NOTE: After services have been shut off there will be a reconnection fee of $__________.