HomeMy WebLinkAboutDrain Layers Permit 106 Berle Road vomit of OiW4 Ightboor
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
Fee Paid $...........2Q,,.Q0....... By Qwn.e.r....to...,Bui.1 di.ng....D.e}gar.tment.,.....'1..1=1.5.-.7..2......... Permit No. .....................7..3.-3k.....................
Date 04...Jua.B.,.....19.73.............................
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein
for repair ......... or construction XX.... of an individual sewage disposal system concerning which the following
information is submitted:
1. Owner of Property ...........Qarlo...rgate,.le.o.................................. Address of Owner ...6.9...Ash...R.P..aa........................................................
2. Location of Property .....l.Qlp......Berl.e....Road.................................................................................................................................. Lot No. .......... +.............
3. Type of Structure ..............Dwelling..........................
(Dwelling, Commercial Building, Store, etc.)
4. Number. of Families or Persons to Occupy Premises .........One (1)...family............................................................................I.......................
5. Number of Bedrooms ..Faur....(4)..................
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank ............1...,25Q........................... Material of Septic Tank ......Arrow....'.!Lo-Boy!!_ -, concrete
8. Soil Conditions: Type of Soil .............................................................................................................................................................................................................................
(Sand, Gravel, Clay, etc.)
Maximumground water table ..............................................................................................................................................................................
9. If not served by public water supply:
Distance from Owner's well ...7..5...ftA................................................
Fromadjacent wells .............................................................................................
10. Distance to nearest water course, drainage ditch, storm drain or embankment .......................................................................................
11. Percolation Tests: Time for 1" drop in soil test ......Ni.ne.te.en....(.1.9.)....minute.s............................................................................................
Classificationof soil ....................................................................................................................................................................................................
12. Minimum square feet of effective seepage area required225.....sq...ft....per....b.edraom.......total....Q.i'....9QQ....sc�.,....it.
13. Leaching System: Number of trenches ................................................ Length ................................................... Width ...........3..c4....ft................
Total ................................................ Other .........................................................................................................................................................................
14. Plot Plan Attached. .....Ie.o...............................................
15. Layout Approved. ....................................................................
16. This permit expires ..........Q4....Augu—s- ..,....1.9.7..3 1.973..................................................
Signature ... :.... ........... ...... ....... ......... ..........................................................................................................................
R. i (Licensed Drain Layer) W9-266363
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
.................................................................................................................................... 19.................. By ...........................................................................................................................................
PollutionProblem abated Date .............................................................................. ............................................................................................................................................
Inspector
WELL;R4LING BOARD" $TATE.OF CONNECTICUT PERMIT NUMBER
iND8-4 11-69 WELL DRILLING PERMIT 16433
STATE OFFICE BUILDING,HARTFORD,CONNECTICUT 06115
LOCATION OF WELL(Town) (Street) (Lot Number) a DATER#
OWNER OF WELL —
INDIVIDUAL, ®'BUILDER OTHER(Specify) arWR
OWNER'S ADDRESS.
69 A t W"Pme 0=9
- BUSINESS TEST Est.No.of
PROPOSED DOMESTIC {--�
l- ❑ ESTABLISHMENT FARM ❑ 1MELL People being
USE OF 3 served.
WELL:.. PUBLIC AIR OTHER
SUPPLY ❑ INDUSTRIAL ❑'CONDITIONING ❑ (Specify)
r
*' {,§KETCH OF WELL LOCATION
" Locate well with respect to at least two roads,showing distance from intersection and front of lot
Location of ipt to at least two roads •z ; ; y Well location an lot and to house{if;Qresent} ±�
lndtcate j lorth�
X use
. «el R�
-Rol4.
{ 1
A��Y 'Ro, e.xT.
rat
Approximate number of feet from well to
negrest source of possible contamination: '
The-undersigned is aware that upon completion of the:well,a"Well Completion Report" containing construction details and information required under Section 25-131
df the 1969 Supplement to the General Statutes must.be sent to the owner,thq Board and the Water Resources Commission on the form-provided by the Board.This.
permit is not valid until all information is filled in and it has been counter-signed by the Director of..Health.or his agent.
ign re) APPLICANT'S ADDRESS REGISTRATiON.NO.
y. Lam+ LM at. 000.
BY To Offlicer or Agent) DATE
ROVED REJECTED
DIRECTOR OF HEALTH
6�O
4Sr �
/ S r
r
1 '
19
6O- o
NOTES SOUTH WINDSOR POLLUTION CONTROL
SCALE: ill = 40, LOCATION Berle Road (Lot 24)
Above sketch also shows approximate OWNER Carlo Prestileo
locatiox of capped sewer eoxxeetiox. TYPE OF WORK Septic Ixstallaatiox
DATE PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY
V d,
t0,25
0
a �\
�G3 I ��
/'CO.00'
—IV /,2; �-Oct' �-J/`°A,-'
-Y
PROPERTY OF
NO. BERLE ROAD SOUTH WINDSOR, CONN.
Being Lot No. 24 on mar entitled, . "Oak Grove acres - Section No. 1 -
Owner & Developer - Carlo Prestileo - - Berle Road & Christine Lane -
South Windsor, Conn. , By S.A.F. - P.A.S. - Scale : 1" = 401 -
Date : Apr. 20, 1971 - Sheet No. 1 of 6".
SCALE: 1 " _ 40' Date :0cl, ,3/,/.972 .
4
GRISWOLD & FUSS, INC .
210 Main. Street
Manchester, Connecticut
WELL COMPLETION REPORT. STATE OF CONNECTICUT
" wDB-5 12-69 REV:9-71 WELL DRILLING BOARD Do NOT fill in
State Office Building STATE WELL NO.
HARTFORD,CONNECTICUT 06115
OTHER NO.
NAME ADDRESS
OWNER >A110 ,t .G
LOCATION (No. &Street) (Town) (Lot Number)
OF WELLBFX-40 O D O t - >} 1 24
BUSINESS
PROPOSED � DOMESTIC ❑ ESTABLISHMENT ❑
FARM ❑ TEST WELL
USE OF
WELL PUBLIC AIR
❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ ((Spec fy)
' DRILLING COMPRESSED CABLE
THER
EQUIPMENT ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION ❑ (Specify)(
CASING LENGTH (feet) DIAMETER(inches) WEIGHT PER FOOT DRIVE SHOE WAS CASING GROUTED?
DETAILS 1 I 19*4 I � THREADED ❑ WELDED YES ❑NO ❑YES �NO
YIELD HOURS YIELD(G.P.M.)
TEST ❑ BAILED ❑ PUMPED COMPRESSED AIR
MEASURE FROM LAND SURFACE—STATIC(Specify feet)I DURING YIELD TEST(feet) I Depth of Completed Well
WATER
LEVEL 20 3.W in feet below Land surface:
MAKE 125
LENGTH OPEN TO AQUIFER(feet)
SCREEN
DETAILS SLOT SIZE I DIAMETER(inches) I IF GRAVEL I I GRAVEL SIZE(inches)FROM(feet) TO(feet)
Lr Diameter of well including
PACKED: gravel pack(inches):
DEPTH FROM LAND SURFACE Sketch exact location of well with distances,to at least
FEET to FEET FORMATION DESCRIPTION
two permanent landmarks.
is
Gravel
15 125 Reddish Rock
E
3'
f
a If yield was tested at different depths during drilling, list below -
t:
FEET GALLONS PER MINUTE
c-
Y.
$ t
x
DATE WELL COMPLETED I PERMIT NO. I REGISTRATION NO. I DATE OF REPORT WELL LLEV(Signaturge,'
DIRECTOR OF HEALTH