HomeMy WebLinkAboutDrain Layers Permit 0736 Avery Street . : : TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: �
DRAIN LAYER'S PERMIT
p 804
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Avery Stt 3) on the
side, between
:F1
at premises owned b. a ► f orw yor- JA., .
whose address is
and to R Lay House Drain, Repair House Drain, Lay Main, Other
for R istu'Vie'a iti occupancy or use,
with bad Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with S X'140h PLO—" C
Permit to be issued ytwivoski
the holder of Drain Layer's License No. `` :`" '3 Permit will expire on 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
Signed
Connection Charge Paid Licensed Drain Layer
Issued by f7m t J4 f 2tit
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
TOWN OF SOUTH WI N DSOR
!—EE Grp BUILDING DEPARTMENT
By South Windsor, Connecticut �Jo,
Application for Permit to Install o Re ai Individual Sewage Disposal System
Application No._-io 6
TO THE BUILDING DEPARTMENT: Date. 19 10
A permit is requested f repair r construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property J'00of �cAEA��vr� Address of Owner '73�,, v�2U S- .2E.,r
2. Location of Property S A.- Lot. No.
3. Type of Structure �LA y(= ri� No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises CttE C f) F A M t y
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank i w t N Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,Clay,etc.)
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 7 , C 2 6 k 16 `f(4 P&.-Onsr u5«L
Signature
_&�O'�,
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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Permit Issued c9tt)
',� Installation Completed, Inspected and Approved <ry 6 °wAV-z 1970 B
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