HomeMy WebLinkAboutSeptic Repair 92 Colony Road N
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NOTES SOUTH WINDSOR HEALTH DEPART1ENT
LOCATION lam• oed
OWNER v
TYPE OF WORK iP ct-;r
DATE 6 l 9-F6 PE IT PIPE
-
INSPECTOR RD DRAWN BY
Fs? SOUTH WINDSOR HEALTH DEPARTMENT APPLICATION NO.
Y �GATION FOR SEWAGE DISPOSAL SYSTEM
own= LOCATION 21-
?MCEATION TESTS: (Record all. testa) SOIL MOISTMr:
Date iQn, med., low, eta.
TEST READINGS
HOLE #1 HOLE HCLE #3 HOLE #4
Time Reading Time Reading Time Reading Time Reading
xi Iv
TABULATION OF TEST RE;LTLTS
Depth presoak Minimum .Percolation Rate
Role Location (Iach_s) Ers. ) (Mies./Inch)
1 _
2
3
4
CBSERPATION PITS: (Record all pits) Ground Water Table:
'ate tear Max., Below Max., --,.cc
`OTL DESCRI?T`10,,'+�
71"F A r7'0c PIT B -- - FTIT C - PIT D ---
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TABULA^'IOIQ OF OBSERVA'lOff FITS
Ground Soil
Pit Locaticu Depth Ledge At Water At McttZ ng A;--
A - ------- - -
B
C
D
Over)-
' '1AY-07-2002 TUE 09:06 AM SK I P'S 8608760428 P. 02
SKIP'S INC.
Ellington, C f
(860)875M2332
L;fxisting septic SYStem Iocsitioll
Adds : v CJ, ' 4=10r Up It:
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Work Mo.- � �'� � a—.11ox Gust:.- -
Drefil WM*am, drm" e1ta*hv samollon distances of septic%yalem f kslbllalivre,
lew'duda all W prt farvtlpty etfatfIOW IS proMlda cif mw&m ale tecntd of Ilia unfits syetaw kwalioit:
IIYa1lt`*lglply Mlab:Irftd oilier fealfaffN ��t tttifk,tNr1►Mril!loil boxes,lieltclf erxle,dry wane,palletise,putaula
st+y fftd tq 80 r�ena And 114 Itksrllitnl Aluo 11*01e Um eeptle lank slip and
. '� ' tMah Auld•A;nlnpodllell��f>f.�'a t'I1Alr,A'x t V+dry witllrt eta
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TOWN OF SOUTH WINDSOR
HEALTH DEPARTMENT
Application for permit to install a new/repair subsurface sewage disposal system. To the Health Department,
Town of Sou Windosor. C'& � 9 /
Fee Paid � Date 6� 2 Permit Number
As a su surface sewage disposal system installer licensed in the State of Connecticut, 1
�bN ��PcE- a1 Kvi 4D_ L. 'tbb a?s-23 3 2 03 2S
Name, Address, Telephone Number, License Number
hereby a�Ply for a permit to construct/repair a subsurface sewage dis osal Syt/,"
m located at
� Coo
l co v y 7� 5 o 0TW W c �u��_ and owned by (1� e S _
Street, Address, �Lot Nu b r � Name
Address
Information to be supplieA by Applicant:
Type of dwelling If non-residential, estimated daily flow
Residential,Commercial,Etc.
Number of bedrooms Size of lot
N umber of fixtures above basement
Tubs,Sinks,Toilets,Etc.
Number of fixtures in basement, if any ,
Pumped or gravity flow,
Type of water supply w 5 t,l %_ . If private,type of well
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 12-5 b Type of system C[ STt wb—
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
I
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.
Permit Received by + l'� Date V ��
Si Jl1canf&0_censefu'b'J
For Office Use Only
Permit issued by Date
System installed by Q 5 �✓ - 0 25
Final Inspection Approval Date J "�