HomeMy WebLinkAboutSeptic Repair 50 Colony Road Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT'
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
FeePaid $............:1.r`.<,"'7..... By Check...No........2447................................................................................................. Permit No. ................... '.':. '...........................
Date ............ I ....... ..........
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 . .,�, ::;,:;• , c�,. Address of Owner �t. ... r, t.�.�,.,, i..............................................
............................................:.. ............................................
2. Location of Property ....... Lot No. ..............................
3. Type of Structure "s j ";., ,
...................................................................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ..........Q..ti.: ...................................................................................................
5. Number of Bedrooms ...;;;as}:: .t.....�. :'r.............
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank ..i f .";:',".j''........................... 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 ........................................................................
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 ................
:.'•?`::
,.
13.. Leaching System: Number of trenches .................:.............................. Length ............ ..................................... Width ...................................................
Total . Other :rs.,....(�} :> ..::;5:;..
14. Plot Plan Attached. ......:.::..................................................
15. Layout Approved. ............Xes.............................................
16. This permit expires '
,y-
Sign ! " r l " ;
ature .:. ... ..... ......... ....:............................................................
t: a. (Licensed Drain Layer)
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
.................................................................................................................................... 19.................. By ................................................................................................................................................
Pollution Problem abated Date ...........1..3....Sepl embe.n.,.....19.7..2... ....... e'lviz�...Bdward.B.a....J.r.,�..............................................................
Inspector
N
A:
0
'*z
NOTES SOUTH WINDSOR POLLUTION CONTROL
Not drawn to scale. LOCATION 50 Colony Road
S TT, DD #1 #2 OWNER Ovide. Bachand
A 16 2'+ 3TE 3 - TYPE OF WORK Septic Repair
B 36 40 55 36 DATE 0 - - 2 PERMIT 2- b PIPE4" O.B.
-- - -- - _ - INSTALLER_-- -Adam_ Ini_-2065 - - ----
INSPECTOR ME DRAWN BY ME