Permit Process Form - Permit Application
 

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SEWER CONNECTION
THE CITY OF CLEVELAND
DEPARTMENT OF PUBLIC UTILITIES
DIVISION OF WATER POLLUTION CONTROL
IMPORTANT: The City is not responsible if the measurements given on said permit are not correct.

SEWERS

To Department Of Public Utilities

The undersigned applies for permission to inch house sewer or drain from House No. on Sublot No. of Allotment; located on the side of which lot has a frontage upon said street of feet and is owned by and thereon tenements, occupied as and desires to connect the same with Sewer, branch of Sewer, to be done in accordance with the ordinances governing the same.
 
(Only Alphabets)
(Owner)
 
By and at the request of the above named person (Only Alphabets) hereby agree to execute the work on said sewer or drain in strict conformity with the provisions of the ordinances provided for the tapping of public sewers or drains, and the rules and regulations of the Department Of Public Utilities now in force. And the undersigned further agrees to hold the said city harmless against all claims for damages to person and property which may be occasioned in any manner by the putting in of said sewer or drain.
 

(Licensed Sewer Builder)
 
Contact Information
 · Email
 · Name
 · Phone number
 
READ CAREFULLY
NO WORK OF LAYING OR REPAIRING DRAINS OR SEWERS CAN BE COMMENCED OR CONTINUED WITHOUT THE PERMIT BEING ON THE GROUND, IN THE HANDS OF THE SEWER BUILDER OR OF ONE EMPLOYED BY THE SEWER BUILDER.
Applications for permits to connect with sewers must be made by the owners of the property to be drained, or by their legally authorized agents and must be accompanied by a clear description of the premises to be drained as provided in the provided in the printed form of application issued by the Department of Public Utilities.

Notice must be given at the office of the Commissioner of Streets as to the time when the pavement upon any street or public highway is to be taken up for the purpose of laying or repairing any private drain or sewer.

All House Sewer Connections laid within the lines of any street or Public Highway must be made in the presence of a city inspector and shall be laid on an inclination of one-quarter inch in each lineal foot of pipe; except in special cases where the same shall be laid at the inclination or depth as directed by the Commissioner of Water Pollution Control.

Inspectors will be furnished on application at the office of the Division Of Water Pollution Control. Inspection is mandatory on both single and double sewer systems.

Application for Inspectors must be made between the hours of 8:00 am and 5:00 pm and all the necessary tools and material must be on the ground, and trench open and in a condition to lay pipe promptly at the time the Inspector is ordered on the ground.

It must distinctly understood that where digging is made in clay soil the refilling must be tamped and not puddled. where the digging is sand the refilling must be puddled.

When drain connections exist at curb lines, said connection ends will first be uncovered and drain trench dug from this point onto private property. Pipe must be laid starting from connecting ends, on proper grade, to building or dwelling to be drained.

Any work not in accordance with above regulations will be removed and caused to be installed properly.

Calls for inspectors - You must call before 8:30am for morning inspection, and before 11:30am for afternoon inspection.

Openings must be secured in accordance to the rules & regulations of the Division of Engineering and Division Of Streets.
 
Office of COMMISSIONER OF WATER POLLUTIONS CONTROL
To Department Of Public Utilities
I recommend that a permit be granted to owner Ave. BOOK NO. PAGE .
 
MEASUREMENTS TO SLANT MANHOLE MEASUREMENTS
 
FOREMAN'S RETURN
Hrs. Foreman Ft. Of Pipe
Hrs. Labor Curves
Hrs. Cartage Stopper
Sacks Of Cement Sacks Of Sand
 
I Hereby certify that the within connection enters lot at a point (Number) feet (Point Of Compass) line of said lot and was properly made by me on day of in conformity with the rules and regulations referred to within; that the connection was made with the recorded junction of said lot without opening or in any way injuring the main or principal sewer; that said connection was laid to true and proper grade, and constructed of sound and substantial (Kind of Pipe) sewer pipe, with the joints properly sealed and tight and that the hole was left clean and in good condition.

     Measurement used was feet inches
     Depth of connection at the main sewer feet
     Depth of connection at the curb feet

 
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