HomeMy WebLinkAboutDrain Layers Permit 209 Pleasant Valley TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
TAnt
DRAIN LAYER'S PERMIT »a.s<1�0
. �...�. , 1 9- —
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at am � on the
_side, between�111d
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main;, Other
for occupancy or use,
with—. VM f2 Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, ' INDUSTRIAL WASTES, OR.
Connection will be made with t � �
Permit to be issued to %Uft1U -- --
the holder of Drain Layer's License No. Permit will expire on 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signe , s �1 .
Connection Charge Paid icensed Dra' Layer
Iw o i r
(Sig) Issued by
Tax Collector
. Permit Fee: Paid $ �{
INSPECTION:
INITIAL (Sig)
FINAL ,"" ., (Sig)
APPROVED (Date)
INSPECTO (Sig)
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 209 Pleasant Valley Road
Not drawn to scale. OWNER Patricia Dale
TYPE OF WORK Sewer Installation
DATE - - 2 PERMIT 135 PIPE ,, Plas
INSTALLER Hallowell (Pci-200905)
INSPECTOR HWL DRAWN BY ME
Acaessim'nts and Charges
for '
SANITARY SEWER SERVICE
Town of South Windsor, 1540 Sullivan Avenue 644-2511
Department of Pollution Control, Vibert Road, South Windsor, 289-0185
ccupant Account No,, 5 - 5-0 6l4
ddress
er
ddress y,-,.t o L�i09)
ssessorls-Locations 3=t "} Ma 0A Block 14 Parcel."—
and Records: Volume—,,��, ?age
Zoning omk. n ._.. Uses_
k ez. Acres
,z
-------------
Sketch
(N:)t to Scale,)
Assessment Computation°
Assessable Footage , Foot Assessment $ 0 $ 110 00
Number of Laterals f� � .� ail Assess x nt $ 200,22i _$
`total Assessment 3305.00
At iessment Dt,. Date
Deferred Yes No
Caveat Fib�ad Yeses No��
Paid in Full Yeses No"
To be pzid iti installments Yes No w
9 4n:;:a ;: Payments of plus 5
on unpaid balance
]Lien Filed Yes No
,onnect ion Charge Compu, at .ova:*
XNumber of Units :
(Residential,, School, cr X Unit Connection Charge $ 400.00 =$400.00
Number of Acres:
(Other than Res,,,, Sch. , or wl`a>,,, X Area Connection Charge $
Bonnection Charge Paid in FaIl Date - Z--
Collector f Rev e
kssessment & Connectior ChrXg--)cmputation,- Approve
Town Engineer
r
N
209
S
1
W
j
13,
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 209 Plea�oni-
OWNER
TYPE OF WORK
DATE PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY C.K.