HomeMy WebLinkAboutDrain Layers Permit 889 Pleasant Valley TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
'560G6 q
DRAIN LAYER'S PERMIT NO '75
1p►Art
•
19 16
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at*I& �r�AsA#-4"t on the
side, bqtweenLj*oAA
at premises owned b, rv , "�t 4 t,N
whose address is tAt
and to. Lay House Drain, Repair House Drain, Lay Main, Other
for 41 Art 1":Vm occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE INDUSTRIAL WASTES, OR
Connection will be made with
Permit to be issued toAkAJ22 ig i~a *A,1
the holder of Drain Layer's License No.kqin 21r2skla Permit will expire ona 19 + .
The undersigned Drain Layel 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
Signed
Connection Charge Paid $, '' Licensed Drain Layer
AWrA A" (Sig) Issued b "
Tax Collector
Permit Fee: Paid $.tip'
INSPECTION: #M9tft*MO* IS"
INITIAL_ a (Sig)
FINAL " (Sig)
APPROVED (Date)
(Sig)
INS15 CTOR
2.C�-/Y. /44sru.A.,4.
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Assessurs-rits and Charges
for
SANITARY SEWER SERVICE
Town of South Windsor, 1540 Sullivan Avenue 644-2511
Department of Pollution Control,, Vibert Roads South Windsor, 289-0185
ccupantftmajoas" xv Account No
ddress "A un."bw itd .�
er sme , .....
ddresa SAM
ssessor s Location-, Lot #___ Map, Block Parcel
and Records: Volume.__ Page 23
oninga Q - —use.-
Area Acres
Sketch
, Not to Scalp
kssessment Computation-,
kssessable Footage. X Foot Assessment $ s an $
miter of Laterals X 7114;x oral Assessment $ QQ—...!W$' �
Total. Assessment =$ �
Assessment Due Date
Deferred Yes„ No
Caveat Filed Yeses No
Paid in Full Yeses No
To be paid in installments Yeses No
9 Awmal Payments of $ l -plus 5%
on unpaid balance
Lien Filed Yes No
:onnect ion Charge Comm tat ion
X Number of Units
Resident is L School, or Ctw chi 1. x Unit connection Charge $4W _$
Number of Acres -
,Other than Res,, Schorr or Ch _, X Area Connection Charge $ •
;onnection Charge Paid in Full: -ter- Date
Collector of Revenue
►ssessmeut & Connection Charg-:! c potations Approved
Town Engineer
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