HomeMy WebLinkAboutApplication - City Vista ` TOWN OF SOUTH WINDSOR
WATER POLLUTION CONTROL AUTHORITY
APPLICATION FORM
Application No.
Date Received
Date Scheduled For
Applicant Elaine D. Gerlt
Address P.O. Box 1132 South Windsor, Telephone No. 860-644-2565
Owner oT Record on Land Records Same as AWli_cant
Owners Address
Property Description:
Assessor's Map # 65 Parcel # 77 Vol. 1967 Page 97
Project Title: city Vista
Inquiries to be Directed to: (name, address, telephone no.) judy s hul e , Design Professi ona 1
Inc. , 165 South Satellite Road, South Windsor, CT 860-291-R755
Approvals Previously Received (Check) IWA P & Z ZBA
Purpose of Application: (Check all that apply)
1. Sewer Extension/Connection -- Residential Use
a. Subdivision X
b. Single Unit
c. Other Expl.ain
d. Type o A pproval: Concept Final_X
2. Sewer Extension/Connection -- Industrial/Commercial User
a. New Connection
b. Request to Increase o—w ate
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. IndustriaUCome cm 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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Applicant's gnature atel
r' i re ate
(See Reverse Side for Application Submittal Procedures)
1msso/W C,Vapplicadon
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