HomeMy WebLinkAboutDrain Layers Permit 0165 Avery Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:South Windsor, Connecticut `71!r
List No.: _
DRAIN LAYER'S PERMIT N? 657
ept. 2,,1974 , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
165 Avery Street
the work indicated below at on the
side, between
Nialmlais Sive
at premises owned by
whose adAess is Same
and to X Lay House Drain, Repair House Drain, Lay Main, Other ,
for Roiti4e$tial occupancy or use,
with 01t8 Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with Six Ixck r1astic Pik
Permit to be issued to JOU A. Lamawt
the holder of Drain Layer's License No.W9-206/88 Permit will expire on 10/2 /74 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
9/20/'t4 Signed
Connection Charge Paid Licensed Drain Layer
Issued by Frank S. Smitk
Tax Collector
Permit Fee: Paid $
15,00***
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED o/t/?Q (Date)
FJS (Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION ��F
OWNER
TYPE OF WORK
DATE PERMIT 7 PIPE ,,
INSTALLER
INSPECTOR DRAWN BY =
. .t). 4 y
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South-Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
`s TO THE BUILDING DEPARTMENT: 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is.sub t ed: ItliC/Vot.,a too
d
1. Owner of Property Address of Owner
2. Location of Property AK- Lot. No.
3. Type of Structure ! No. of Bedrooms
(Dwelling,Commerci uilding,Stor etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets +► Urinals La oriel cIT Bathtubs l
Showers Kitchen Sinks _` Laundry Tubs Garbage Grinder Other/�
6. Liquid Capacity of Septic Tan 6 QeO, Material of Septic Tank,
7. Soil Conditions: Type of Soil Maximum ground water table ' '
(Band, ravel, lay,etc.)
4
8. If not served by public water supply: Distance from Owner's well from adjacent wells �
9. Distance_ to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
12.' Leaching System: Number of trenches Length Width Total
Other
ti
E Signature '
( ice sed Installer
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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