HomeMy WebLinkAboutSeptic New 17 Carman Road down of OVW4 lyinbsor
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
y 'a " �'" Permit No 7� 4`'Fee Paid $................�.:.�..:.}.... B << ►,..,F..:.....::........:7..,:....;................................................................................................. :;:.......................................
Date ..; ....�C:;a�,f..,... , ..........................
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,. .;: ,.:i.,`.,(�,:.,.....:.:'..:;.. �.... e ::....s <<�..,r.....i.`.e Address of Owner Ls:... i:7.T,1I1�F ... C?.rl •..........................................
2. Location of Property .........>. a::::........................................................................................................................................................................ Lot No. ..........::':...............
3. Type of Structure
(Dwelling, Commercial Building, Store, etc.)
4., Number of Families or Persons to Occupy Premises ............Qnc.....(.:1.1......f..,arllli.0.3j.................................................................................................
5. Number of Bedrooms ................................................
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank ......................................................... Material of Septic Tank ..........................................................................................
S. 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 .......... ....::...............................................................................................................................................
Classificationof soil ....................................................................................................................................................................................................
12. Minimum square feet of effective seepage area required ....................::'':'::: "......: {.....:...:,.r...............................................................................................
13. Leaching System: Number of trenches ................................................ Length ................................................... Width ...................................................
Total .....................................I.......... Other ......................................:.................................................................................................................................
14. Plot Plan Attached. ........ >.;.;................................................
15. Layout Approved. ....................................................................
16. This permit expires .............
r
Signature .. ...........................................
r:
I .... .:.,.... S .Sg:..................................................
(Licensed Drain Layer)
Installation Completed, Inspected and Approved
p p pp ved in accordance with State Public Health Code and Local Ordinances
........ ............................. ......... ......... ... E ..- ............... ls..2 ...... By .. , ,4, f......................, -
..e.... ......... ............................ ................
PollutionProblem abated Date .............................................................................. ........................................................................................................................... .......,.......
Inspector
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NOTES_ SOUTH WINDSOR POLLUTION CONTROL
Drawing not to scale. LOCATION 17 Carman Road (Lot 2 )
OWNER
TYPE OF WORK Septic Repair
DATE '7- q- Z (. PERMIT 76-18 PIPE
--- - -- - - -- -- - - INSTALLER— - -
INSPECTOR rJ S DRAWN BY
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