A. Residential Or Commercial Building Sewer Application:
To the Village of Seneca, Illinois:
A. THE UNDERSIGNED, being the
(Owner, Owner's Agent)
property located at
Number Street
DOES HEREBY REQUEST a permit to install and connect a building to serve the
(Residence, Commercial Building, etc.)
at said location.
1. The following indicated fixtures will be connected to the proposed building sewer:
Number Fixtures Number Fixtures
Kitchen Sinks Water Closet
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 area are attached hereto 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 Village Code and of all other pertinent ordinance regulations that may be adopted in the future.
2. To maintain the building sewer at no expense to the Village of Seneca.
3. To notify the Village when the building sewer is ready for inspection and connection to the public sewer, but before any portion of the work is covered.
DATED: SIGNED:
(Applicant)
(Address of Applicant)
$ applicant fee paid this day of , 199 .
VILLAGE OF SENECA:
BY:
Application approved and construction permit issued:
DATE: VILLAGE OF SENECA
BY:
B. Industrial Sewer Connection Application:
To the Village of Seneca, Illinois:
A. THE UNDERSIGNED, being the
(Owner, Owner's Agent)
of the property located at
Number Street
DOES HEREBY REQUEST a permit
(install, use)
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 discharges, 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 Village.
3. To cooperate at all times with the Village and its representatives in their inspecting, sampling and study of the industrial wastes, and any facilities provided for pretreatment.
4. To notify the Village 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.
DATED: SIGNED:
(Applicant)
(Address of Applicant)
$ applicant fee paid this day of , 199 .
VILLAGE OF SENECA:
BY:
Application approved and construction permit issued:
DATE: VILLAGE OF SENECA
BY:
C. Private Sewage Disposal Applicant:
To the Village of Seneca, Illinois:
A. THE UNDERSIGNED, being the
(Owner, Owner's Agent)
of the property located at
Number Street
DOES HEREBY REQUEST a permit to install sanitary sewage disposal facilities to serve the
(Residence, Commercial
Building, etc.)
at said location.
1. The proposed facilities include: to be constructed in complete accordance with the plans and specifications attached hereunto as "Exhibit A".
2. The area of the property is square feet (or square meters).
3. The name and address of the person or firm who will perform the work is: .
4. The maximum number of persons to be served by the proposed facilities is: .
5. The locations and nature of all sources of private or public water supply within the one hundred feet (100') (30.5 meters) of any boundary of said property are shown on the plat attached hereunto as "Exhibit B".
B. In consideration of the grant of this permit, THE UNDERSIGNED AGREES:
1. To furnish any additional information relating to the proposed work that shall be requested by the Village.
2. To accept and abide by all provisions of the Village Code, and of all other pertinent ordinances or regulations that may be adopted in the future.
3. To operate and maintain the wastewater disposal facilities covered by this application in a sanitary manner at all times, in compliance with all requirements of the Village and at no expense to the Village.
4. To notify the Village at least twenty four (24) hours prior to commencement of the work proposed, and again at least twenty four (24) hours prior to the covering of any underground portions of the installation.
DATED: SIGNED:
(Applicant)
(Address of Applicant)
$ applicant fee paid this day of , 199 .
VILLAGE OF SENECA:
BY:
Application approved and construction permit issued:
DATE: VILLAGE OF SENECA
BY:
(Ord. 83-20, 12-20-83)