HomeMy WebLinkAboutDrain Layers Permit 519 Nutmeg Road (2) pd - TOWN OF SOUTH WI N DSO =
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DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT
'O 62
fkAA'- AV /4 , 19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at X P S/9 Xlb e -lt U 7/2 on the
r, ?
gzfJ4 side, between Ad A;
at premises owned by__�_.1r-.-,'� �I€�.
whose address is
and to Lay House Drain, Repair House Drain Lay Main, Other
for ' ,2 Z7 R/A I occupancy or use,
with Family Units, with , acres.
Type of of Sewage to be connected under this permit:—
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with
Permit to be issued to /2� I /-Jt� d ,
the holder of Drain Layer's License No,4.4 I Permit will expire on V& 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permi and the reverse side
thereof. Applicant has received Town Permit No. 2007 and/or C H D Permit No.
for Oar.
SPECIAL CONDITIONS
76
Signed_ y M .�, ✓ j r' C11"< 1.. I
Connection Charge Paid $ ZW .. �"A-fCXA'!C' I icens-6d Drain La e
(Sig) issued by t
Tax Collector
Permit Fee: Pi S,
INSPECTION:
INITIAL
FINAL '`� � � (Sig)
APPROVED-
(Sig),
INSPECT R
f
Issued By Town of South Windsor Date of Issue
211 (, k Department of Public Works --
Permit No. ND 207 PERMIT Date of Expiration
TYPE OF WORK TO BE DONE: Location:
Connect with Storm Sewer . []
Placing Building Materials . . . . . . [] -_> ,
Excavate . . . . . . . . . . . . . . . . . . . ❑
Curb Cut . . . . . . . . . . . . . A
Construct Sidewalk . . . . . . . . . . . . p
Construct Curbing . . . . . . . . . . . . 0 Description:
Erect Sign
Remove Stump . . . . . . . . . . . . . . . p
Transport Building . . . . . . . . . . . . []
Driveway Ramp . . . . . . . . . . . . . . L-j
MISC. . . . . . . . . . . . . . . . . . . . . . .
Fee $10.00 I BY I Bond I Amount p
Work to be carried on according to the Regulations and By-Laws of the Town of South Windsor.
This Permit to be on the job at all times. Sidewalk should not be obstructed.
Name of Company. % �4�%2 Director of Public Works
(PRINT) �/� Signed
Signed c c v Date Checked
Address I Phone No.
�z� OK By
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As.Se.i swa t u and Charges
for
SANITARY SEWER SERVICE
Towns of South Windsor, 1540 Sullivan Avenue 6442511
Department of Pollution Control, Vibert Road, South Windsor,, 289-0185
)-cupant_xhg C&= C039pe Account No
dd.res 111.9
er .�..e. ... �. _.o.
ddress
ssessor s Location, Lot Map Block Parcel a&
and Records a Volume_,j�,sI Page Imo,
Zoning,. .I ut�ts3a1.......� Use°
&.7ea Acres
f+
T
- k
Sketch
,Not to Scale),,
.s.arso s.�esevso eo aaaa0as
Assessment Computation,
Assessable Footage SM62 x r:ont Foot Assessment $ .�Q �$„ i ► 4�,QQ, ,_
'number of Laterals,- X Lateral Assessment
Total Assessment
Assessment D>se Date
Deferred Yes No
Caveat Filed Yes No
Paid in Full Yeses No
To be paid in installments Yeses No
9 .Arr-a l Payments of $ "lam plus 5%
on unpaid balance
Lien Filed Yes� No
Connection Charge g2 tatior
X Number of Units,
(Residential, School,, or CIE ;hd 6A"X Unit Connection Charge $
Number of Acres,
(Other than Res{, , Scha , or Ch:,x, Ara Connection Charge $
Connection Charge Paid in Ful I c 4/f/: �'
hector of Revenue
Assessment & Conneetior, Clwx&g , ations Approved
Town Engineer
1