HomeMy WebLinkAboutdrain layer permit 959 Sullivan Avenue TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor,Connecticut
List Ne e t 8-600,97
DRAIN LAYER' S PERMIT NO . 131 _
19
Pursuant to written application, permission is hereby granted to the Licensed.Drain Layer named herein to perform
the work indicated below at wn" on the
-mtifs side,
at premises owned by WU r Dievelopmentra on
whose address is
Cater99 Btiwts
Q P, 05wo 06040
and to Lay House Drain, Repair House Drain, Lay Main, Other ,
for ��, occupancy or use,
with Family Units, with *J.g acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES,_OR
Connection will be made with
Permit to be issued toj js MMM 009 ! Inee (jobs Le-OiltjM)
the holder of Drain Layer's License No. Permir'%P� expire on 15 Oetabsa 19-n_
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
Signed
Connection Charge Paid Licensed Drain Layer
%X1 ae NMI (Sig) issued by NOXTAX V. LM ek
Tax Collector
Permit Fee: Paid $
IN ECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
�' nMnfCTOR
r
ASSESSMENTS 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
Account No.
Occupant
Address
Owner
Address Block Parcel
Assessor's Location: Lot#. Map
Land Records: Volume Page Use:
Zoning:
Area Acres
Sketch
(Not to Scale)
Assessment Computation:
x Front Foot Assessment $ = $
Assessable Footage = $
Number of Laterals x Lateral Assessment $
Total Assessment
Assessment Due Date
Deferred Yes No —
Caveat Filed Yes No
Paid in Full Yes No
To be paid in installments Yes No
9 Annual Payments of $ plus 5% on unpaid balance
Lien Filed Yes No
Connection Charge Computation:
Number of Units: - $
(Residential, School, or Church) x Unit Connection Charge $
Number of Acres: _ $
(Other than Res., Sch., or Ch..) x Area Connection Charge $
Date
Connection Charge Paid in Full: Collector of Revenue
Assessment & Connection Charge Computations Approved Town Engineer
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