RESIDENTIAL OR COMMERCIAL BUILDING SEWER APPLICATION
To the City of Nashville:
A. THE UNDERSIGNED, being the _______________ ____________________ properly located at
(owner) (Owner’s Agent)
___________________ ______________________
(number) (street)
DOES HEREBY REQUEST A permit to install and connect a building to serve the
____________________ at said location
(Residence, Commercial Building, and the like)
1. The following indicated fixtures will be connected to the proposed building sewer:
Number Fixtures Number Fixtures
_____ Kitchen Sinks _____Water Closets
_____ Lavatories _____ Bath tubs
_____ Laundry Tubs _____ 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’.
B. In consideration of the granting of this permit, THE UNDERSIGNED AGREES:
1. To accept and abide by all provisions of the City Code of the City of Nashville and of all other pertinent ordinances or regulations that may be adopted in the future.
2. To maintain the building sewer at no expense to the City.
3. To notify the City of Nashville when the building sewer is ready for inspection and connection to the public sewer, but before any portion of the work is covered.
Date ____________ Signed ______________
(applicant)
$_______________ connection fee paid
$_______________ inspection fee paid
Application approved and permit issued
DATE: _____________ SIGNED: _____________
(Approving Authority)
INDUSTRIAL SEWER
CONNECTION APPLICATION
To the City of Nashville:
A. THE UNDERSIGNED being the _________________________ of the property located at
(Owner, Lessee, Tenant, etc.)
___________________________________ DOES HEREBY REQUEST a permit to
______________________ an industrial sewer connection serving the ________________________
(Name of Company)
which company is engaged in _______________________________ at said location.
1. A plat 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 __________________________.
B. 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 adopted in the future.
2. 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 of Nashville.
3. To cooperate at all times with the city of Nashville, and his representative in their inspecting, sampling, and study of the industrial wastes, and any facilities provided for pretreatment.
4. To notify the city of Nashville immediately in 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 ____________ Signed ______________
(Applicant)
_____________________________
(Address of Applicant)
$_______________ connection fee paid
$_______________ inspection fee paid
Application approved and permit granted:
DATE: _____________ SIGNED: _____________
(Approving Authority)