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HomeMy WebLinkAboutSeptic Repair 124Barber Hill Road Barber TOWN OF SOUTH WINDSOR HEALTH DEPARTMENT Application for permit to install a newlrepair su surfa sewage disposal system. To the Health Department, PP Town of South Winds r. 'ia ar'' -- Fee Paid 0 Date S 30 7 Permit Number As subsurfa sewage-- disposal sys m i taller lice d in the State of Conn ticut I �14 1/1 e(0 0 Lb) I P-01 4 -3'70# Name, Address, Telephone Number, License Number h rebp ap ygor , p rj�it to onstru the r a subsurface sewage disposal s tern located at Y,�r�Ch� t� 1( V �K wfAJ�,$r►` and owned by � Street, Address, Number Name Address Information to be supplieA by Agplic�rl Type of dwelling (JAWO(� �'J If non-residential, estimated daily flow Residential,Commercial,Etc. Number of bedrooms Size of lot Number of fixtures above basement Tubs,Sinks,Toilets,Etc. Number of fixtures in basement, if any , Pumped or gravity flow, Type of water supply If private,type of well Public-Private Information to be supplied by Health Department: Soil type at various levels Percolation rate Square feet of effective leaching area required Size of septic tank Type of system Trenches,Drywells,Etc. Number of dry wells, trenches, etc. Distance between individual leaching units. Distance from well on same property on adjoining property Curtain drain required Yes,No Height of system above ground water maximum ground water , ledge impervious soil layer If automatic closing is required,description A PLOT PLAN INDICATING LOCATION OF PROPOSED STRUCTURE, WATER SUPPLY, SEPTIC SYSTEM, EM- BANKMENTS, WATERCOURSES, PROPERTY LINES AND ALSO INDICATING EXISTING AND PROPOSED FINISHED GRADES MUST BE SUBMITTED BEFORE THIS PERMIT CAN BE ISSUED. THIS PERMIT IS NOT TRANSFERRABLE FROM PERSON TO PERSON OR FROM PLACE TO PLACE. NO PART OF THE SYSTEM SHALL BE BACKFILLED UNTIL IT HAS BEEN INSPECTED AND APPROVED BY THE SANITARIAN. SPECIFICATION AND REQUIREMENTS AS STATED IN THIS PERMIT MUST BE MET AND ANY CHANGES MUST BE APPROVED BY THE TOWN SANITARIAN BEFORE FINAL APPROVAL WILL BE GIVEN. THIS PERMIT SHALL NOT BE CONSTRUED AS PERMISSION TO CREATE A NUISANCE CONDITION NOR IS THIS SYSTEM GUARANTEED BY THE HEALTH DEP 7RTMENT. l J;,Permit Received by Date I Signature off plicant&License Number For Office Use Only n L , t� Permit issued by Date System installed by Final Inspection Approval Date FORM#2 State of Connecticut Depament of Public Health APPLICATION NO. INVESTIGATION FOR SEWAGE DISPOSAL SYSTEM Owner Location �Ia+ l 2L CL� f'tJ� �0� . PERCOLATION TESTS:!(Record all Tests) 07 SOIL MOISTURE:(Date) (high,med.,low,etc.) TEST READINGS ---. .HOLE a HOLE un e HOL—ReadinE g une HOLE e ea g Time ov 8' o/y3 `Z�D v / TABULATION OF TEST RESULTS Hole Location <Y Depth Presoak Time Percolation Rate OBSERVATION PITS:(Record all pits)_; �l��a7 Groundwater Table (Date) (Near max., Blow maz etc.): SOIL DESCRIPTIONS PIT -PIT PTT: PTT: Jr fob= /IPA i �` l� ,fits Dian 51 " cd 1 fkrc� TABULATION OF TEST RESULTS Pit. Location Depth Ledge Ground Water Mottling I/I/00 49 FORM#2 Con'd State of Connecticut Department.of Public Health Investigation for Sewage Disposal System i LOCATION DRAWING SPECIAL CONDITIONS CONCLUSIONS System design larSer than 2,000 g.p.d. Suitable for sewage disposal Water supply watershed Possible seasonal high groundwater Unsuitable for sewage sal Watercourse,marsh or pond- Possible Possible seasonal flooding Additional investigation required Limited suitable area Excessive Slope(over 25%) Retest during wet season Marginal soil(30-60mins/inch) Shallow ledge-(less than 5 fl.) Monitor,groundwater thru wet season Underlying tight soil(less than 4 8.) Other Engineer's plan required DESIGN RECOMMENDATIONS Investigated by ©.�� � TitleJPW ,,— Confirmed/witnessed by Title Comments: 1/l/00