HomeMy WebLinkAboutDrain Layers Permit 0759 Avery Street TOWN Of S01 'H WI N DSOR
i DEPARTMENT OF POLLUTION CONTROL
!� s South Windsor, Connecticut z
p` k DRAIN LAYER'S PERMIT
O 310
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fi ' 19
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Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
- �` - � . sue, side, between
at premises owned by k r
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other ,
fork ° occupancy or use,
with 41 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 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 reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
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SPECIAL CONDITIONS *-
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Signed a r
Connection Charge Paid $ "` Licensed Drain Layer
(Sig) issued by
Tax Collector
Permit Fee: Paid $
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INSPECTION: f
INITIAL ;` " (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
. TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.TO THE BUILDING DEPARTMENT: Date. 7=/0 19 G 9-
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: _ A kaPP
1. Owner of Property Address of Owner
2. Location of Property C 54 Lot. No. �
3. Type of Structure tN No. of Bedrooms
{Dwell ng,co .mercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets/ 2 Urinals Lavatories Bathtubs _
Showers Kitchen Sinks 1 Laundry Tubs Garbage Grinder Other _
6. Liquid Capacity of Septic Tank Material of Septic Tank C;�h C r"T
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_c f _Classification of soil
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11. Minimum square feet of effective seepage area required- �3 �
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12. Leaching System: Number of trenches Length off Width G _ Total
Other
Signatu ,Z,f
(Licensed nstall
(Sketch showing all minimum distances and other details r ifred below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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LAND OF IRINA RUPNER
TOWN OF SOUTH WINDSOR, CONNECTICUT
SCALE: 1" = 40'
L.S. #4395
Rockville, Conn.
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