HomeMy WebLinkAboutSeptic Repair 335 Buckland Road u TOWN OF SOUTH WINDSOR
HEALTH DEPARTMENT
Application for permit to install a new epair subsurface sewage disposal system. To the Health Department,
Town of SOT Windsor.�
Fee Paid 10, 00 t61S Date C. I I ��7 Permit Number
As a ubsurface sewage disppo�sal syste inst Iler(�license in the State of Connecticut, I _
ao lu Wn�cAldh C"rte14V �-l�il 'Po �e� 3y?w3�95 co s
Name, Address, Telephone Number, License Number
hereby ap ly for a permit to construct/repair a subsurface sewage disposal system located at
3�S �ockIAn.c� dl, andownedby ±hGMA5 -4 1'C4t11eew t
Street, Address, Lot Number CjCvlUwor Name
Address
Information to be suplied by Applicant:
Type of dwelling e5idlPukiak If non-residential, estimated daily flow
Residential,Commercial,Etc.
Number of bedrooms Size of lot
Number of fixtures above basement 5 21AtbO AS
Tubs,Sinks,Toilets,Etc.
Number of fixtures in basement, if any ,
Pumped or gravity flow,
Type of water supply JT'011A If private,type of well of-((led
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 DEPARTMENT.
LPermit Received by Groa�N.� ' O bs Date l4 17'�S'7
S' ture StAplicant&License Number
For Office Use Only
Permit issued by Date
System installed by
Final Inspection Approval A Date
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NOTES SOUTH WINDSOR HEALTH_ D_EPART14ENT
b-4)0" w jh ill, LOCATION 3s ai,c 1 d Vd
1Cvw over OWNER d' C ot,,vt
TYPE OF WORK Re- 'r
DATE 6-laj? PERMIT PIPE
INSTALLER IQap)cA-i o(i
INSPECTOR -D7 DRAWN BY R )-
MIK SOUTH WINDSOR HEALTH DEPARTMENT APMCATION NO.
• 13VESTIGATI017 FOR SEWAGE DISPOSAL SYS M4
Owner 01 Gals vn.o r LOCATION 33 r Rv L
PEXOT.ATION TESTS: (Record all. testa) 6-//- r<7 SOIL MOISTURE.:
Date , med., low, etc.
TEST READINGS
HOLE #1 =2 #2 HOLE #3 EOic
Time Reading Time Reading Time Treading Time Reading
ll E7
TABULATION OF TMT RESt71TS
Presoak *Minimum .Percolation Rate
Hole Location (?nch s) Ers. ) (Mins./Inch)
1 3 n�=f 1e� i-S MiH f itic�
2 TA-
3
4.
OBSER7A^_'I0N FITS: (Record all pits) oT L--87 Ground Water Table
5t—e
-02L DESCRIPT1014—: .
PIT A PIT B ?T-T C ! PIT D
d- M -'asp 50i r
,a-3N
i
G,w a:Q R'h
h o maMe ,
Y►1A G- w -_
TABULATIONd OF OBSER7AmTON FITS
Ground Soil
Pit Location Depth Ledge At dater At MotV,{na A:
A
B
C
D
Over)
a F �fQ1t3N 6� Sf�,N 6�wc��o��
Cf+ T11G' L ) C
r + T• a^r S G •c— �•
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Mortgage Survey
Property Of
THOMAS C. be ItATHLEEN T . 0 t CONNOR
335 BudklFnd Rd. South Windsor
Scale* 1:tt-401 Dec. 40 1981
RR Zone. . .j:. ..
Lot nonconforming to miry, width of 175. ft, and rgrea 'cSf 40,QQ0. aq. ft.
Dwelling nonconforming to min. front yard of 50. ft.
I hereby certify that this survey and the hounds and maesaremeaft
lCO/yN� shov;n heienn are substantially correct; that the title tines and lines
o CI of ectuai possession are the same; that the buildings are bested as
��� KF7T�l✓ /CG shown and do not encroach over or upon atraet, title or building
hncs; that there e•e no violations of zoning ordinaries, re5irictiorts
Of other rules and reguietions inrespect to the location of Bald
buildinr.s; and that there are no?asements or encroachments affect. ..
%o. 1311 Ing this pro,erty apparent from a careful Insp.ctlon of same other
then those shown and depicted hweon. t
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}�, X� 1it•+ r ,.j., r°I b ! �' REGt8TEF3F.D LAND SUR41EY6R'* IfO0
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