Building Sewer Application

User ID#:            
Subject:    

Property Owner Information
* First Name:                 
* Last Name       
(This e-mail address will receive electronic notifications, it does not have to belong to the property owner)  
* E Mail:          
* Phone        
* Address1               
   Address2      
* City:                 * State  
* Zip             

The person named above is the Please Select Property Owner Owner's Agent

Permit Information
This permit applications is for a   Please Select Residence Commercial Building       
If commercial / industrial use, please list the estimated gallons per day
usage:

Installer Information
Company Name (if any)   
License # Of Installer          
Installer's Name  (First & Last) 
Installer's E-Mail
Installer's Phone
Address 1      
Address 2    
City         State     
Zip Code:

 In consideration of the granting of this permit, the applicant agrees:
A.   To accept and abide by all provisions of Chapter 31 of the Brewer City Ordinance and of all other pertinent ordinances and regulations that are adopted in the future.
B.   To maintain the building sewer at no expense to the City.
C.   To notify the City Engineer when  the building sewer is ready for inspection and connected to the public sewer, but before any portion of the work is covered.