City of Cranston, Rhode Island |
Application for Residential/Commercial Connection with Sewerage System |
Plat No. ________________ |
No. ___________________ |
Lot No. ________________ |
The undersigned, being owner or agent, of the property hereby applies for a permit for the connection of a sewer service connection for the __________ |
Old __________ |
New __________ at No. __________ and St. __________ that the same may be connected with the __________ (Name of Street) Street common sewer. |
Part __________ Sheet __________ |
The undersigned agrees to strictly conform to the laws and ordinances and instructions previously given relating to sewers, and to the rules and regulations that are now in force or may be adopted in relation thereto, and also to the plumbing and drainage laws and ordinances as far as they relate thereto, and fully aware of penalties that may be invoked. |
Date of Application ________________ |
Signature _______________________________________________ |
Owner's Mailing Address __________________________________ |
Date of Application in Sewer Department by ____________________ |
Cranston Sewer Division by _________________________________ |
Approved by __________ Plumbing Inspector |
Approved by __________ Owner's Agent/Owner's Attorney |
(Ord. 2013-24, § 1, 7/22/2013)