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Rug 09 07 11 : 55a Frederick White (209) 333-0073 p. 6 <br /> REQUEST FOR NEW CONNECTION <br /> WOODBRIDGE SANITARY DISTRICT <br /> 19720 BL•'NEDICT DRIVE <br /> WOODBRMGE,CA 95258 <br /> (2O9) 368-0900 Tax(209)368-0554 <br /> vvi,udhr�<t�rKcVrtibcalu!ml.nci, <br /> Project Information: <br /> Owner- Fred Wnite _ — Date: 7-16.07 <br /> Address: 19215 Perryman Rd, Lodi, CA 95242 <br /> P11onc: 209.403-7191 <br /> Contractor: owner <br /> property Addr 96 E. Woodbridge Rd. <br /> Lot Size: — ---14960 sq ft <br /> Parcel No: 015-220.17 — <br /> Purpose: single family residence <br /> (Commercial) Number of offices: ( ) Number of employees: <br /> (Residential) Number of bedrooms: ( 3 ) Other: <br /> 1- THIS FORM: Return this form to our office for pre-inspection. <br /> 2. THE PERMIT: in a few daVs we will call Vou for an appointment to pay the fees and <br /> pick Up Your WILL SERVE PERMIT. <br /> 3. CONTRACTOR: The Customer finds a contractor to do the work. <br /> Before the tines are buried, the Chief Plant Operator must <br /> inspect the lines and put the final signature on your "WILL <br /> SERVE PERMIT". (Call WSD office for appointment) <br /> Ordinance 87--1 Section 415 ... every new connection granted shall be VOID, if the <br /> connection is not made within one (1) year from the date the 'WILL SERVE PERMIT" is <br /> Issued. If a connection is disconnected, then a new connection permit is required <br /> before any structure may again be connected. If a structure ceases to use the <br /> connection for one (1) year, then a new connection permit shall be required. Section <br /> 416 ... in the case of unusual hardship, the Board may grant a variance to any of the <br /> above. <br /> Fees R" b to: Woodbridge Sanitary District. <br /> connection Fee: $ 2128.00 <br /> inspection Fee & Permit: 25.00 <br /> $ 2153.00 NO FEE SHALL BE REFUNDABLE. <br /> Pre-inspection approval: <br /> T. Brett Moroz, Chief Plant operator —i — _ —Dates:— - <br />