(A) Each applicant for water supply or service shall file with the city an application therefor, in writing, setting
forth the name of such applicant, the location of the premises for which such supply or service is sought, the name of the owner of the premises if other than applicant, the nature and size of such service and the extent of such supply and the proposed use thereof.
(B) The form of the application for water pipe connection shall be as follows:
Address _______________________________________ ________
Application for service pipe connection to City of Mattoon.
I desire to make service pipe connections with _____for a supply of water on the following premises, _______________________________________ ________________
Owned by _______________________________________ _______
Address _______________________________________ _________
Occupied by _______________________________________ _____
Lot ______ Block ______________ Street ___________________
I agree that the pipes and fixtures used shall be only such as are approved by the city and that same shall be placed in accordance with all applicable building code and public works regulations of the city. The pipes and fixtures are described as follows: _______________________________ And should I ever desire changes of any kind made in my water service pipes or fixtures, before any such changes are made I agree to first make formal application to the city.
Signed _____________________________________
The above application is accepted __________________________
Superintendent
The work as per specifications herewith (Over) is completed and ready for your inspection.
Date ____________________ 20____ Plumber ________________________________________
On reverse side of card is location of service box, size of corporation cock, size and style of service pipe and remarks.
(Ord. 2021-5442, passed 6-1-2021)