HomeMy WebLinkAboutSeptic Repair 48 Blue Ridge Drive vomit of #nt#4 Ightboor
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
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Fee Paid $.... ....� ...... By 0` .—...... ...�...... .... ............ Permit No. pDate .............. 1.....:.7 ......................
Pursua t o written application, permission is hereby granted to the Licensed Drain Layer named herein
for repair or construction ......... of an individual sewage disposal system concerning which the following
information is submitted: (�
1. Owner of Propertylt..Qy/l7oiJ.. ... O Q�ie- .... Addr of Owner ..............T-- ............................................,.............
7... /.�......... �� r
2. Location of Property ........../........ ......... .....l.........................................................::.:... Lot No. ......
p rty
3. Type of Structure ...............—.....5 .���....... ..!.....:"................. ,�.,G.1/.t�iL 1. ..`..
(Dwelling, Commercial Building, Stor�tc.)
4. Number of Families or Persons to Occupy Premises ................................................................................................................................................................
5. Number of Bedrooms ................................................
6. Average Daily Flow ...................................................
r'/Cj, Manufacturer and
7. Liquid Capacity of Septic Tank ... .. ,/d 7��
� ',w.......... Material of Septic Tank ....................................I.....................................................
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 ........................................................................
From adjacent wells .............................................................................................
10. Distance to nearest water course, drainage ditch, storm drain or embankment .......................................................................................
11. Percolation Tests: Time for 1" drop in soil test ..............................................................................................................................................................................
Classificationof soil ....................................................................................................................................................................................................
12. Minimum square feet of effective seepage area required ...................................................................................................................................................
13. Leaching System: Number of trenches ................................................ Length ................................................... Width ...................................................
Total ................................................ Oth .................................... ...... ...... ...... .................................................................................
14. Plot Plan Attached. .. {L' 01 17, O ✓Qn
15. Layout Approved. .....................................................................
16. This. permit expires ................. ...............................................................................................
V Va a/ 2�
gnature ......................................:.. .... . ..... ............................. .............................:..............................
(Licensed Drain Layer) dp @ a`1
Installation Completed, Inspected and Approved in accordance with StateTublic Health Code and Local Ordinances
................................... V.� i 7
.............�1......................................... 19.................. By ......... ............................................................... ..........................................
PollutionProblem abated Date ................................:............................................. ..........................................................................................................................._...............
Inspector
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LOT # 153, "BIRCH HILL ESTATES"
SECTION #7
TOWN OF SOUTH WINDSOR, CONN.
Scales 1"= 40 '
L.s . 4395
i Rockville, Conn.
p TOWN OF SOUTH WINDSOR
TOWN HALL
SOUTH WINDSOR, CONN• 06074
DEPARTMENT POLLUTION CONTROL
Date
Sewer Septic System x• • • . ' '
The Sanitary , 7 4C .... . . . . . . . . . . . . . . . .
46
S3 has been installed and completed
or lot #
. ith the Town of-South Windsor ordinances
in accordance w
and regulations. n �,-�
Accepted and Approved �— �,CIG 04
_� Date
By