HomeMy WebLinkAboutSeptic Repair 117 Dart Hill Road TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENTC�
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date 19 4
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: J
1. Owner of Property Address of Owner_��� j ��✓!
2. Location of Property n Lot. No.
3. Type of Structure +r No. of Bedrooms
-
Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank p Material of Septic Tank
7. Soil Conditions: Type of Soil _Maximum ground water table
(Sand,Gravy,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Total
Other
Signatur/erdetails
nsed Installer)
(Sketch showing all minimum distances and required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved- I/ z_ 19 By
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Department of Pollution Control r
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SOUTH WINDSOR, CONNECTICiIT
DRAIN LAYER'S PERMIT
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Application for Permit to Install or Repair Individual Sewage Disposal System
Fee Paid $............1.0.00...... ByBQ.uf:faz'd...Qhe.ck...Nth.-....3907................................................................. Permit No. .7?.-70.........................................
Date
i Pursuant to written application, permission is hereby granted to the Licensed.Drain Layer named herein
for repair ..XX or construction ......... of an individual sewage disposal system concerning which the following r
information is submitted: frE'
1. Owner of Property ...........J0.8-aph...Bout.faxed................................. Address of Owner ....1.47.:?k....Main..at .Q.t...........
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,. 2. Location of Property ......1..1.7....Dart...Hill...Road........................................................ ........ ............................................ Lot No. ....... X:....
3. Type of Structure ..............Dwellin
" (Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ...........One.....(1:)....family.....................................:...........................
5. Number of Bedrooms .,Three....(3)..............
6. Average Daily Flow .........................................: r a
Manufacturer and
7. Liquid Capacity of Septic Tank ......................................................... Material of Septic Tank kxiating.
.........................................................
8. Soil Conditions:Type of Soil
(Sand, Gravel, Clay, etc.) 61
Maximumground water table ................................................:...........................:....................................................................... ..... 5 .
9. If not served by public water supply:
Distance from.Owner's .well .......................75....titA............................. f
From adjacent wells .............................................: r
10. Distance to nearest water course, drainage ditch, storm drain or embankment ...............................................................................: .....
'_. 11. Percolation Tests: Time for 1" drop in soil test .......Repai..r.........................................................................................................................................:.. ..... '
Classificationof soil '...................................................................................................................................................................................................
E' 12. Minimum square feet of effective seepage area required ...................................................................................:
13. Leaching System: Number of trenches .. .................. Length ................................................... Width ..........................
ta
Total ................................................ Other?t0.-f.t....equa.l.izier....trench....installed....ae,xo.tsa...pa�� pf x
14. Plot Plan Attached. N..a.................................................. front yard.
15. Layout Approved. ....................................................................
16. This permit expires .........1.1... .tR.bel'.x....1.97 ............ia
.... ...... .
17. Reference Pollution Complaint 13-72 ) � '
Signature ....... .. .......Rod erick�....N9-20.6391..)......................................... .......
(Licensed Drain Layer) 'n
t µ
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances r Y
. .................................................................................................................................... 19.................. By ........... ......................................................................................................................... ,
' s
1..1....Aug4gt.......1. 2 Melvin Edwaidsi; Jr.
Pollution Problem abated Date 97..................... .........., ......
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