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HomeMy WebLinkAboutSeptic Repair 260 Ellington Road . - _. ..-,-.� �+.., .�,r.s-..r� ;'C"�r.;aBv�.�-.oe ..•„-'.e.�,,,�+!�„vr+�+,�,--+-s. .�v�. .,...,.j..,e`"'.$tRY�-ai*tiNCCa+4Yi+a'q;;L'.'�=��'.5'7i0'°i�i�'ov,;:tawz.:�„_'!�r"',,.: TOWN OF SOUTH WINDSOR HEALTH DEPARTMENT Application for permit to install a new/repair subsurface sewage disposal system. To the Health Department, Town of South Windsor. Fee Paid Date Permit Number a ubsurface sewage disposal system installer licensed in the State of Connecticut, I ' 6 Name, ddress, Telephone dumber, License Number hereby apply for a permit to construct/repair a subsurface sewage disposal s stem located at � ; '11 _k 9✓ and owned by rr� Street, Address, Lot,N ber Name Address Information to be supplied by Applicant: f Type of dwelling If non-residential, estimated daily flow Residential,Commercial,Etc. Numberof bedrooms Size of lot Number of fixtures above basement Tubs,Sinks,Toilets,Etc. Number of fixtures in basement, if any ; Pumped or gravity flow, Type of water supply Ph-ll',4-e— . If private,type of well �Ll� 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 Type of system 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 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 - Date Signature of Applicant&License Number For Office Use Only Permit issued by Date System installed by Final Inspection Approval Date FORM-#2 State of Connecticut Department of Public Health APPLICA-11UN NU. INVESTIGATION FOR SEWAGE DISPOSAL SYSTEM Owner Location 2.�✓d �lLI t�7 / PERCOLATION TESTS:(Record all Tests) SOIL MOISTURE: (Date) (high,med.,low,etc.) TEST READINGS . .-HOLE HOLE -HOLE HOLE Tune —Reading Time, g Time Kiimg Time Reading. rez TABULATION OF TEST RESULTS Hole Location Depth Presoak Time Percolation Rate I OBSERVATION PITS:(Record all pits) Groundwater Table (Date) (Near max.,Below max.,ete.)`, SOIL DESCRIPTIONS PIT PIT.PIT _ PIT: WGv TABULATION OF TEST RESULTS ' Pit. Location Depth Ledge Ground Water Mottling 1/l/00 C-b b b 49 FORM-#2 State of Connecticut Department of Public Health APPLICK11UN NU. INVESTIGATION FOR SEWAGE DISPOSAL SYSTEM Owner Location bLCi;f__ - PERCOLATION TESTS:(Record all Tests) '�. SOIL MOISTURE: (Date) (high,med.,low,etc.) TEST READINGS . ..HOLE HOLE .HIE HOLE Time Reading Tune Reading Tune Rea g ime R TABULATION OF TEST RESULTS Hole Location Depth Presoak Time Percolation Rate OBSERVATION PITS:(Record all pits) Groundwater Table (Date) .(Near max:,Be16w may,ete.j' SOIL DESCRIPTIONS PTF P PIT. PIT. p - z-o C3 �0,.Q 3�r ��ps�il _ Sao W�LY S TABULATION OF TEST RESULTS Pit Location Depth Ledge Ground Water Mottling 1/l/00 6v 0 b 49 TOWN OF SOUTH WINDSOR HEALTH DEPARTMENT Application for permit to install a new/repair subsurface sewage disposal system. To the Health Department, Town of South Windsor. Fee Paid 10 990 Date Permit Number a subsurface sews a disposal system inst Iler lic nsedd in the State of Connecticut, I ame, Address, Teleph ne Number, License Number hereby apply for a permit to construct/repair a subsurface sewage disp sal system located at f ►' and owned by A/ hire- Street, Address, Lo umber Name Address Information to be supplied by Applicant:Type of dwelling ��y�:U�rL� 1 j If non-residential, estimated daily flow Ao -i-•-- Residential,Commercial,Etc. Number of bedrooms Size of lot Number of fixtures above basement o2 S`1n�S .� 5 Tubs,Sinks,Toilets,Etc. Number of fixtures in basement, if any , Pumped or gravity flow, Type of water supply Pe��� 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 Type of system 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 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 Date ` — 3 ce Sign re of Applicant&License Number For Office Use Only Permit issued by Date System installed by Final Inspection Approval Date 0 5 F Coelo, RAYMOND W. PECK, JR. ROUTE 198. CHAPL(N, CT 06235 4SS-9796 /Dv well si. a F� C) W r A h - C 8 Cay Q ----_--------- Distance from corner"A" /%4 �ZIS 00 Distance from corner"B" /� Distance from corner"C" ` Distance from corner"D" j 1 i { a Ld - 7s _ I 3 NOTES SOUTH WINDSOR POLLUTION CONTROL LOCATION 260 Fl l l u cc L,, OWNER aL i d 1, TYPE OF WORK DATE ;)-3..-)q PERMIT 2YZ12 , PIPE INSTALLER Cn e tq INSPECTOR DRAWN BY STATE OF CONNECTICUT DEPARTMENT OF HEALTH SERVICES 79 Elm Street — Hartford, Connecticut 06115 DATE_ - 1 ► ?-�/7� 1 SUBJEICT: 5d�+T"l-L W 1 IV S c7 CONN., REVIEW OF F NGINF.ERIi'tG PLAN FM A CMa"Mmi). SUBSURFACE SEWAGE DISPOSAL SYSTEM W •P d M_ ^Rg-K Fy°`�R.t��S �1VL• �� �Lt�.tJG-TON QZ� • TO: RAF RT �� Tvc..� 'R.S. -taw N H/A t iv D S o FROM: THEODORE C. WILLERFORD, PRINCIPAL SANITARY ENGINEERI ENGINEER: CcM( L_ L_U LE{` DATE RECEIVED_l IAlo Z21 REASON FOR SUBMISSION: L�i Ej MINIMUM PERCOLATION RATE POORER NEW CONSTRUCTION THAN 30 MINUTES/INCH SHALLOW IR _ HIGH I.MXIMU I GROUND WATER LEVEL REPAIR ROCK - E OTHER D DESIGN SPECIFICATIONS: ZS� G• P DESIGN PERC. RATE �j MIIS.jIN. SEPTIC TANK l UlJ d GAL;. LEACHING SYSTEM -TR&j.lc-t-k - 7 5�x3` FILL SYSTEM �- FEET . CURTAIN DRAINS RECaMMED ACTION: RAPPROVAL Q APPROVAL WITH MODIFICATIONS OR PROVISIONS NOTED ON ENCLOSED PLAN. CONDITIONAL APPROVAL SUBJECT TO FURTHER TESTING PRIOR TO INSTALLATION AS NOTE3 ON ENCLOSED PLAN. APPROVAL DENIED. SITE UNSUITABLE FOR SEWAGE DISPOSAL. APPROVAL DENIED. INSUFFICIENT INFORMATION ON PLAN. APPROVAL DENIED. REVISE AS NOTED ON ENCLOSED PLAN AND RESUBMIT. APPROVAL DENIED. FURTHER SITE INVESTIGATION REQUIRED. COM'EM: -lam COPIES TO: Sincerely DIRECTOR OF HEALTH SANITARIAN ENGINEER ENVIROM4ENTAL HEALTH SERVICEVIVISION OTHER Phone: 566-2195 APPLICATION FOR SITE INVESTIGATION AND PERCOLATION TEST -4o.7.4ion to be supplied by Applicant: Name and Address of Applicant Location of Property. //[�,�"�v� kod Address, Street, Lot Number Name- and Address of Owner Site of Lot Type of Water Supply. Signature of Applicant Date Information to be supplied by Health Department: Description of Property Soil .Conditions: Observation Pit #I(Fresr/ :f L��l Observation Pit #2(rc�d �! . LGy) Observation Pit #3 O t0 rr 'r _to E gird��iser Trh�y .sa yet -LL _to a 'Meol-Fthe r,lfy s`.Ed to 36 tom_ rVVj-jx-- xa-'Ac/ 20 to f> CVL edc sa,�,Cj to- t 0 ��' lc� c.�T $"/Z / to G.LA-) to to - to to Log of Percolation Tests: Test lWater Time Rate Test Water Time Rate Hole Depth Time Level Interval Drop Min./In, Hole De th Time Level Interval Drop Min,/In, Design Rate Design Rate Remarks 1 In cke 6 w 4l��'r'+�r hF� a�f 3 loon �xr d'f t� q/`u ck Tests conducted by_ _�, ►r��_� Date /v 2E-� pproved for septic system - yes no �. /�l!/,.�f /�yvir,r(� pCC��SG r;f' ��1/t �r0✓kc� tv�er P1uMs !/�wrave Q/ �// signature of Sanitarian_ Date /'Z-3 -�`� 4, TOWN OF SOUTH WINDSOR • HEALTH DEPARTMENT Application for permit to install a new repair subsurface sewage disposal system. To the Health Department, Town of South Windsor. Fee Paid 20-� ©k c Date Permit Number 79-,13 As a . subsurface sewage� di .posal system installer licensed in the State of Connecti ut, I _ a�C � SC..c� �n � 3 �.�1• Name, Address, Telephone Number, License Number hereby apply for a permit to . construct/repair a subsurface sewage disposal system located at 26d & Ic&Av andowned by David Ply "L Street, Address, Lot Number Name Address Information to be supplied by Applicant: Type of dwelling If non-residential, estimated daily flow aSU G,tl b Residential,Commercial,Etc. Numberof bedrooms Size of lot a.";i- Number of fixtures above basement �•� Tubs,Sinks,Toilets,Etc. Number of fixtures in basement, if any , Pumped or gravity flow, Type of water supply C v A,_ If private,type of well Public-Private Information to be supplied by Health Department: Soil type at various levels 148y a-ao d :ice s��l Percolation rate S f414 IL? Square feet of effective leaching area required Size of septic tank f16 as Type of system !-po-,cz 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 n v Yes,No Height of system aboveground water maximum ground water ledge impervious soil layer If automatic closing is required,description 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 Date /2--3 " 79 Signature of Applicant&Lic se Number For Office Use Only QQ 'Permit issued by Date System installed by /2 3 `�4�inal Inspection Approval �• �(� Q Date y r { s I I i i f i 7S� I NOTES I SOUTH WINDSOR POLLUTION CONTROL LOCATION 260 El j i w c� OWNER OaL,I. Y <<,61 TYPE OF WORK DATE a-3 i PERMIT -727 PIPE INSTALLER INSPECTOR DRAWN BY �' • i