HomeMy WebLinkAboutDrain Layers Permit 54 Northview Drive TOWN OF SOUTH WINDSOR
` DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT NO 83
19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at <"—, j �rJ,, .
' 3� on the
1166"T" side, between ��jj Tu,t t ttt �Cld4A:�
at premises owned by �«q.'+r,,' an. �' '94FA AlAy.4 J e ta&4m K r
whose address is `�
and to Lay House Drain, Repair House Drain, Lay Main Other
for ` ;�:mil' occupancy or use,
with {, r,rr` Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with a A y 5
Permit to be issued to .4 "o Cc
the holder of Drain Layer's License Now" �f ,.' 'ti+y'� 'I Permit will expire on Abe,"
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the perrifIt and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid $ y ' .' , Licensed Drain Layer
T (Sig) issued by r�..•'�,,.,.�' �}j
7_
ax of ector
Permit Fee: Paid $
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED i�LYA�e+�tJ f (Date)
(Sig)
INWECTOR
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ASSESSITENUS AND CWGES
FIDR
SANITARY SEVIER SERVICE
Town of South WL-idsor, 1,540 Sullivan Ave-twe 644-2511
'XPv,-ftWP-')t Of Pollution Control, Vibert Road, South Windsor, 299-0185
Occupant Account No 57(1 / g-S-
Addrerss
Owner
— J.,_ab__,iSkpy rnatd Jz _& &an K
As
Map____Ll Block�663 Parcel91
V e)I A 11�z � .122 Page 220 ..
isu
res
vs, Y4-
j'7 i,
Sketch
Foot Assessment $____&50 = $
Assessment = $20 AOO_
Te-ltal, Assessment =
A&ue.-smevc Due Date
Deferred
Caveat Filed yes No
Paid in Full Yes—�—
To be pbvid in Installmnts Yes No
9 Arwo.wl. Payments of $ -120.44 * -)I7wT73/Z--'
on unpaid ba la,nw
Connection Char COM Lien Filed Yes l��— No---
. RU
---Ea
x ukpx of U lis ,a
Scbocl, or Church)_ 1 X Unit Connection Charge $ 00.00 .--$-AO-9-0-00
s -,,,r Ch. X Area Correct ion 'h-arge$
to
Golle. or
iow�, Appro-ved
i v-,
Twn Engineer