HomeMy WebLinkAboutApplication - Green Lane TOWN OF SOUTH WINDSOR
WATER POLLUTION CONTROL AUTHORITY
APPLICATION FORM
Application No.
Date Received
Date Scheduled For
Applicant 3M) ConS'r artixr Cep-,. Inca
Address Telephone No. tyw),) .)_ O- 4k
Owner OT Record on d ecords Co. ne. .
Owners Address pOOA RagL lA),n, wr, C�r 0007tf
Property Description:
Assessor's Map # Parcel # t�;�, (y Vol. qcn Page 5
Project Title: g mr rn. d arC o n ! ubcWisi bv�
Inquiries to be Directed to: (name, address, telephone no.)
SGIA.{'h 'Sa� rI'lf Jet&)IJLJ
Approvals Previously Received (Check) IWA P & Z ZBA
Purpose of Application: (Check all that apply)
1. Sewer Extension/Connection -- Residential Use
a. Subdivision _ y _
b. Single Unit
c. Other plain
d. Type o A-pproval: Concept y Final
2. Sewer Extension/Connection -- Industrial/Commercial User
a. New Connection
b. Request to Increase ow Kate
c. Change in Nature of Waste Discharge
d. Other Explain
e. Type o Approval: Concept Final
3. Appeal of Sewer User Charge
a. Residential
b. Industrial/Co emm icr al
4. Sewer Assessment
a. Establish Sewer Assessment
b. Appeal of Sewer Assessment
c. Change in Use of Property
5. Regulatory Appeal ; Explain
6. Other Explain
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(See Reverse ' e for pplication Submittal Procedures)
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