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Gown of OvW4 Mitbour
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT'
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
FeePaid $ ......... By ............................................... .................................... Permit No ........
Date ....................:............:.........................................
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 .... .�.0 ..::................................................. Lot No. .........:....................
3. Type of Structure ...................::::....:..........:::.....................................................................................................................................................................................................................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons,to Occupy Premises ...............................:::... i
5. Number of Bedrooms .............................................
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank ... ......... Material of Septic Tank ...... .....:.....................: ...............................
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 ...................................... Other ........................................................................................................................................................................
14. Plot Plan Attached. ...............................................................
15. Layout Approved. ....................................................................
16. This permit expires .........................................................................................................
..........
Signature ..................................................................................................................
(Licensed Drain Layer)
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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BEING LOT *9 ON MAP ENTITLED
" SAND HILL ESTATES" MAY ?, 1970
REVISED .' NOV. 197E
CONNECT/ CUT LIGHT a POWER COMPANY ,
50.00 /00.00
\ 1 �
0
I 1 N LOT 9 LOT /O
I I
LOT 8 I o 1
O --- 54.00 --- 1 O
O1 53.0`0 O
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1 Aj PROPOSED
1 38.5 3 8.R. - R.R. 58.5
I
1 11/000 gal tan*
1 50 f V/L DING LINE
1
I � I
E75.00 TO P.C. OF _ 150.00
CUL-DE -SAC
CARRI A G E DRIVE
it
ri'AV�a_ it _•, t�... ,:, L.
L NI H r 18 _ T.J,-
FOR-
r M A N
CA RR/A GE DR/VE — SOUTH WINDSOR, CONN.
y SCALE.- / " = 40 ' N 0 V. /3, I972
✓A MES E. S HEEH Y L.S. 7034
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TOWN OFF SOUTH WINDSOR
TOWN HALL
SOUTH WINDSOR, CONN. o6074
DEPARTMENT POLLUTION CONTROL
Date = 6� . -& . . . . . . .
The Sanitary Sewer . . . . . . . . Septic System k X
o
. . . . . . . . . . . . . .
or lot # has been installed and completed
in accordance with the Town of South Windsor ordinances
and regulations , -: ; t'O
Accepted and Approved
Date
By -- ------—---- -----