HomeMy WebLinkAboutDrain Layers Permit 195 Diane Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut , 2
List.No.: _
DRAIN LAYER'S PERMIT N? 1333
I6- 17 ., 1977
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to"perform
the work indicated beJAw at j/�.. on t e
side,.between
at premises owned by Po A,,7 <� j• 1 ZC9 o, ,rerez?( )
whose address is
and to Y—Lay House Drain, Repair House Drain, - Lay`Main, Other
for
occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE j, INDUSTRIA WASTES (, ), OR ( )
Connection will be made with—
Permit
Permit to he 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.
SPECIAL CONDITIONS
Signed
Connection Charge Paid ��3 License Drain Layer
ul
16 —/7-77 Issued by
Tax Collector _
Permit Fee: Paid $ ' 6
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
,/Z� &!= (Sig)
V , INSPECTO
7
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X
77
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SOUTH WIN-OSOP' POi-I_UTION CONTROL
i_OrATION fy' e
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TOWN OF SOUTH WI N DSOR
131.11LDI.NG DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No, t!✓
TO THE BUILDING DEPARTMENT: Date` 19
—4f,
A permit is requested for repair or construction of an individual sewage dispose system oncerning which the,
following information is submitted: ASolver N
1. Owner of Property " Address of Owner
Qom' � t
2. Location of Pro
A Lot. No.Ea
3. Type of Structure a A No. of Bedrooms
( welling,Commercial Building,Store,etc.)
4. Number of Families or 4kvw~to Occupy Premises Ili ►
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs. _
Showers Kitchen Sinks_ Laundry Tubs Garbage Grinder Other -
6. Liquid Capacity of Septic Tank-- do gal Material of Septic Tan
7. Soil Conditions: Type of Soil !' tf Maximum ground water table i * "
and,oravel,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 %3 Length Width �®`` Total!���
Other
Signature,..
ceased net",J 9
(Sketch showing all minimum distances and other details-required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By