HomeMy WebLinkAboutSeptic New 326 Buckland Road :s
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Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
10.00 Check...No.�....48 . .............................................................................. Permit No. .73.-21.............................,....,.......
Fee Paid $.................................... By ................................... 7.
Date ...............2. ...AP..?^ l.x.....9.73........
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein
for repair of an individual sewage disposal system p ......... or construction individual g p y concerning which the following
information is submitted:
1. Owner of Property ...........R�.Phpxd....H•....L#Ylgar...................... Address of Owner ...32.6...Buckl#.Ad....RO.Ad..................................
2. Location of Property .....SMA......................................................................................................................................................................... Lot No. ..............................
3. Type of Structure ..............Dwellixg......................................................
.............................................................................................................................................................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ..........Z:Wo. ....fMiliea..................... ............................................................................................
5. Number of Bedrooms ..FQur..,.(4)................. .....
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank .1,250.,,,9a],loxa..,,,,,, Material of Septic Tank .....Arrow,,,,:7 ;Q qrete...........................
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 ........................................................................
Fromadjacent wells ............................................................................................
10. Distance to nearest water course, drainage ditch, storm drain or embankment .......................................................................................
11. Percolation Tests: Time for 1" drop in soil test ......Repa�ir..................................................................................................................................................
Classificationof soil .................................................:............................................................................................:.....................................................
12. Minimum square feet of effective seepage area required5. ... .q... t . !.25 p..er bedroom
. .............................................................
13. Leaching System: Number of trenches ................................................ Length ................................................... Width ...........3.!Q...f t-................
Total ................................................ Other .........................................................................................................................................................................
14. Plot Plan Attached. .....Np..................................................
15. Layout Approved. ....................................................................
16. This permit expires .........2.,5....Juxe.......1..97.3............................................................
Signature .................Jpp .. .....................................................................................................................
R.P. (Licensed Drain Layer)W9-206363)
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
.................................................................................................................................... 19.................. By ................................................................................................................................................
PollutionProblem abated Date .............................................................................. ........................................................................:............,..................................... ...............
Inspector
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