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HomeMy WebLinkAbout1975-9-22 - 240 Brookfield Street - Septic Application clnwrxt of OoW4 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 $. '...... By 3 E . g. Permit No . . ....: ......._. a........ .............................................. Date !a?.R .. x..............tql."�... Pursuant to 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 Property .................................................................................................. Address of Owner .......................................... 2. Location of Property ......`::::: ......................................................................................................................................................................... Lot No. ........: ..:;............,.. 3. Type of Structure ...............: ................................................................................................................................................................................................................... (Dwelling, Commercial Building, Store, etc.) 4. Number of Families or Persons to Occupy Premises ... f". ? '" 5. Number of Bedrooms 6. Average Daily Flow ..........................................-....... Manufacturer and 7. Liquid Capacity of Septic Tank ..1 . .. Material of Septic TankCt74 -' ........... 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 ;':;i..:................................................ Fromadjacent wells ............................................................................................. 10. Distance to nearest water course, drainage ditch, storm/drain or embankment ....................................................................................... t ....: -� 11. Percolation Tests: Time for 1" drop in soil test ........ :..:....:. Classification of soil .......................................................... r ....... 12. Minimum square feet of effective seepage area required M,� i ..:: ..... :., ....... 13. Leaching System: Number of trenches ................................................ Length ................................................... Width ................................................... Total ................................................ Other ......................................................................................................................................................................... 14. Plot Plan Attached. .......:..::!`.:............................................. 15. Layout Approved. .................................................................... 16. This permit expires ..:..::.:.......:.:.::. V Signature ................................................................................................................................................................................... (Licensed Drain Layer) Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances .................................................................................................................................... 19.................. By ........................................................................................................,....................................... \ Pollution Problem abated Date ................................:............................................: .............................................................................. Inspector r r BOO �F Exisr. MON. A f` f- Ip CE4CN/N,9 1 l a a REa l 40 /000 sat r f//4p, - fr. - - 3O .0 0 - � (10 • Q W tp o! L o T LOT 13 12 Z BE D410 LAT 13 OBI A MAP ENT rl OF 'Po` a iVdOR' TAT ES BROOKFI:.:I13 ST. rJR Ir FIN "t" 3EPTIv J,i�?T. Mt - - 7H e�Zio.SOR, ON 7 .AIL" ;ram BED- 0 0:1 1 t :� t X 1` i r11i1 r*. 3 *�` ti IBA T 1 N :� C _D • } 11 W OR b. 'KEN ` ro By SPA,:M 12 I a :•jS=Y -,�-,ir-[FY THL3 Pl"'N { li.�t�.u�.i a X' v " L VIOLA:1'1 5721 703 N/F SOUTH WINDSOR HEIGHTS IN C. pROpERTY OF R. J. AL.EXA NDER I NC. N©s oR,r - SOU7BRooKFi4op s . 26 / 9fAPRIL