HomeMy WebLinkAboutDrain Layers Permit 752 Pleasant Valley TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
1 {
I►�" 31+0 DRAIN LAYER'S PERMIT N? 84
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
1
the work indicated below at' �
on the
side, between,. -
i
at premises owned f„ WAAL
whose address is
and to _Lay House Drain, Repair House Drain, Lay Main, Other
forr.i.■..L, '
occupancy or use,
with_ ^JkA 't# Family Units, with
acres.
Type of Sewage to be connected under this permit:
INDUSTRIAL WASTES, OR
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. r Permit will expire on 411
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit reverse si�'e
thereof. Applicant has received Town Permit No. and/or C H D Permit NO.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid $4W } ns Drain Layer
Tax Collector (Sig) Issued.,;by -
Permit Fee: Paid $
I SPECTION: 0004K N*i $197
INITIAL
(Sig)
FINAL (Sig)
APPROVED 7 (Date)
(Sig)
INSPECTO
N
0
EDI
I�oTEs;
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DPAW
TOWN OF SOUTH ' '1ND5OR
STD �5 South Windso .
r, Conn
,,II
WELL DPJLLER'S pERMIT DateR.0 J'I......° . ... 7
..................... .......................
ofthe fi .............................................
. .....................
Y to that I •• (address)
(we) am (are) a well driller dul '
Y and currentl re "' "
'Commission and do make application herewith for a Well Driller's Permit in accordance with the Provisions Of the 1963 Session of the Conner ' Y tore wit a State of Connecticut Water Resources
t Le ature, for a well to P visions of Public Act 187
Name of Property Owner:........... bed o he pro e y of:
... ................
Address of Property
.............
p Y Owner . ! ..
Address of Premixes .......... ..... ................ ..............
on which well is located:...........................
The approximate location of the well will be as shown on the.ever
The undersigned is aware that upon completion of this well the above data,together with a well I of i
under c se side of this permit.
( );and (rd of Public Act 187 of the 1963 Session must be sent to: Water Resources Commi '
Building, Hartford, Connecticut on the farm entitled "Well Com letio og information required
p part"which has�be�,,ssion, 223 State Office
registered driller
This permit is issued for a well located
Applicant ........
as shown to the above named well dr-1
Public Act 187 of the 1963 Session o r in accordance with the Provisions off the Connecticut Legisla u this...
WHITE— dayof. ,
GREEN_ISSUING AGENT , 196...5�;
... . ... ....... .......................
APPL
PINK—LOCAL(HEALTH OFFICER
:ANARY—WATER RESOURCES COMMISSION
c'lding ;ial(Over) or Town Clen•k....... .. ......................
�. T ♦. s
-r v4. '+ ►
Ai�set:swents and Charges
for
SANITARY SEWER SERVICE
Town of South Windear 1540 Sullivan Avenue 644-2511
Department of Pollution Control, Vibert Roads South Windsor, 289-0185
ccupant ,..,......�._._. _ � Account No,,
4.ddress
Address ., , _�, _
Assessors Location z Lot _ _ Mapes_Bock &t Parcel, 48
Land Records: Volu.me_=,..z,.. Page _. ,
Zoning o_n Use: - . Re, Y 9..�
..®..�. ,�:: . Acres
Sketch
s ;fir to Scalz
Assessment Computations
Assessable Footage , "a9I' : Foot Ass-:P,;3sment $
[%umber of Laterals. Assess imnt
Total Assn Is€ent =$
A,'::�vyssment M Date
Deferred Yes No
�;aveat Fi'llg ud Yeses Now,"®
,Paid in FBI 1 Yeses No*
To b_') pr id iv installmw.'ttss Yes No
9 Payments ,.xf $ UFOXT' plus 5l.�
on unpaid -balance
Lien Files Yes No
:onnect ion Char -at= :'A ;;
X Number of Unit
'.Residential, School, t r CF a,y h: I X Un'.-'t Connection Charge $400*0.0 .00
Number of/Acres :
;Other than Rest, Sch, , or C;�> ., X Arf,.a Connection Charge $ ;
',00nnction Charge Paid in r's �G�� z. Date Z-9c
/�JQ
�Q Collector of Revenue
issesswent & Connectior. Ch, rg � ations Approved
Town Engineer