HomeMy WebLinkAboutSeptic Repair 850 Ellington Road TOWN OF SOUTH WINDSOR
J HEALTH DEPARTMENT
Application for permit to install a new a ai subsurface sewage disposal system. To the Health Department,
Town of South Windsor.
Fee Paid i(_Q-0 CU g Date /Z—24 : 2- Permit Number
As a subs rface sewage disposal system -installer licensed in the State of Connecticut, I
1&2424 T� �� ��40-7 G
Name, Address, Telephone Number, License Number
hereby a ly, for a p rmit to construct/repair a subsurface sewage disposal system located at
b f and owned by
Street, Address, tot Number T Name
Address
Information to be suppliegby pp 'cant:
Type of dwelling If non-residential, estimated daily flow
Residential,Commercial,Etc.
Numberof bedrooms Cf 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 _-&89 . 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 by Date
Signature of Applicant is se Nu er
For Office Use Only
Permit issued by L9 Date I7- -2-9-9—Z_
System installed by
Final Inspection Approval Date j-46--93
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ElEl
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rc 12'
11 iny,
NOTES SOUTH WINDSOR HEALTH DEPARTMENT
moo.
LOCATION i t c" -��
OWNER Lc v.�j
TYPE OF WORK It-
DATE l-6- PERMIT PIPE
INSTALLER Ll rf Ck_
INSPECTOR DRAWN BY
J0 SEPH P.
No. 850 EL L I NGTON k,
SOUTH WINDSOR, CON
SCALE: I INCH = 40 FEET
ADDITI
REVIS
PETERSEN a HOFFM
1169 MAIN ST., EAST
I HEREBY CERTIFY THAT THIS MAP IS SUBSTANTIALLY CORR
WITH CLASS A-2 OF THE CODE OF RECOMMENDED PRACTICE
SURVEYS. AND MAPS, THAT THERE ARE NO ZONING VIOLATIO,
` BUILDINGS SHOWN HEREON WERE LOCATED UPON THE GROUND.
41
2. o k�NN
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r
co 00
0
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PROPOSED
WOODWORKING SHOP O PA' 6�' 400
'HEIGHT TO BE LESS Y� O vE///ctEJ
THAN 12') ./ p V E
NOTE.• DEL I VERIES WILL
BE INFREQUENT AND
[.Lj O O !� 11 i Jet., 2
USUALLY MADE BY VAN. 98�"5�
00
e \
of NousE 2'
/ gso /
p0
2 hAirq i l Q RCk PORCH . O
Y .y
Q Q
.�
ca ES M t7
�Z o.
a JqY %298IRON PIP'
0 NC 0.19, .OF COR.
c J, SF
ZONE A-20 MINIMUM ENTS:REQUIR M RS
E �
c�
LOT AREA 20,000 SQ.FT. 0
LOT WIDTH 100'
LOT DEPTH 150' t
FRONT YARD 40' ?
SIDE YARD 10' (20'AGGR.)
_.EAR YARD _ 40'
i,a
FVK .*jg SOUTH WINDSOR hl1 ALfh e. CA=Ml 710.
INPESTIGATION FOR SEWAGE DIS?C`SAL SYSM - O?Yf
Own = LOCATION "j
PE COrATION TESTS: (Record all. tests) SOIL MOISTURE:
Date , med., ov eta
TEST READINGS
HOLE #1 tad""fir R= #2 -CLE #3 HOLE S
Time Reading Time Reading Time Reading Time Readins
1/P
fZ�— 13'/L
2� t
TABULATION OF Tz'MT R UtLTS
Presoak minim— Percolation Raze
Hole Location ( ea) (E:rs. ) (Mina./Inch)
1
2
3
OBSERPATION PITS: (Record all pits) Z•-p 2- Ground Water Table:
rpm (Near max., Be law Max.
OTT., DEnCRIF?'TC`'o
PIT A FIT B FTT C I PIT D
U lei, <1
S�; l
1177-)L� rr "led ,lc-td
:2 3 ,,lord )
TABULATTOF OF OBSERVA'!TION FITS
Ground Soil
Pitt: "r 3 Locaticu Depth Ledge At Water At tic t tz nr.
A
B
C
D
Cve
SOUTH WINDS 0 R HEALTH •2• Investigation-for sewage, s osa.1. SyY � ti
DEPARTMENT
SPIETAL CONDITIONS
System design larger than 2,000 g.p.d. Water supply - atersh,ed
High ground water (less than 14 ft. ) possible seasonal high
ground seater
Watercourse, marsh or pond Possible seasonal flooding
Limited suitable area Slope over ISV
Marginal soil (30 - 60 mins./inch) Shallow ledge (less than 7 ft.)
Underlying tight soil (less than 4 ft) Other
CONCLUSION
Suitable for sewage disposal
Unsuitable for sewage disposal
Additional investigation required
Retest during wet season
Engineer's plan required
DESIGN RECOb2oMMATIONS
Investigated by Title
Confiraed/Witnessed by. Title
Comments;
Hench.mark location Elevation