HomeMy WebLinkAboutdrain layer permit 938 Sullivan Avenue TOWN OF SOUTH WIN DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT N� 132
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned b
whose address is y
and to _Lay House Drain, Repair House Drain, Lay Main, Other
for t-�wNA�wo!!� — occupancy or use,
with � (0 Family Units, with acres.
Type of Sewage to be connected under this permit:
(-.SANITARY SEWAGE — INDUSTRIAL WASTES, OR
Connection will be made with ,A " *
Permit to be issued to
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 ri'� everse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
g a '
Connection Charge Pai Si ne Licensed Drain La�er,.,,
— r (Sig) Issued by11t�a
Tax Collector
Permit Fee: Paid $ .��
INSPECTION: 1 + wMM„
INITIAL (Sig)
FINAL (Sig)
APPROVED IS Andlg&e J= (Date)
(Sig)
INSPEOfM
N
Sv�LUAn/
v�Nv�
NOTES Not drawn to scale. SOUTH WINDSOR POLLUTION CONTROL
LOCATION 938 Sullivan Avenue
OWNER Carlos M. TORRES
TYPE OF WORK
DATE 0 -19-72 PERMIT 132 PIPE6" Plastic
INSTALLER Hoe W9-20 110
INSPECTOR ME DRAWN BY ME
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
Occupant m Account No.
Address
Owner
Address
Assessor's Location: Lot# Map Block Parcel
Land Records: Volume Page
Zoning: Use:
Area p'' Acres
Sketch p,
(Not to Scale)
Assessment Computation:
Assessable Footage x Front Foot Assessment $ = $
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 $; = $
• Connection Charge Paid in Full: Date
Collector of Revenue
Assessment & Connection Charge Computations Approved
Town Engineer