HomeMy WebLinkAboutSeptic Repair 1104 Ellington Road (2) 4 F
(!own of 00W4 10inboar
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT `.
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DRAIN LAYER'S PERMIT
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Application for Permit to Install or Repair Individual Sewage Disposal System
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Fee Paid $............IQ*.Q.Q....... By .................Ce.heck..Humber......2-3A5.................................................................. Permit No. .-72n,0..............
Date ...............0&..:Jt7xt�ts...,1.9'1 ..,:
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named he
for repair XX..: or construction ......... of an individual sewage disposal system concerning which the followix} " F
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information is submitted: }T ,
.. 1. Owner of Property F•W• �I'��....... ....... Address of Owner ...11•a+.••E],lrtgton,,,Raad
p rty .............................L ....................
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2. Location of Property ....SamO.......................................................................................................................................................................... Lot No. .... t'4.4`;
3. Type of Structure .............. welling............................................................................................................•............................................................................. ........ ... 1
(Dwelling, Commercial Building, Store, eta)
4. Number of Families or Persons to Occupy Premises ..........on�O.....0.)....f family........................................................................... .......: ... t
5. Number of Bedrooms
6. Average Daily Flow .................................................
Manufacturer and
7. Liquid Capacity of.Septic Tank Material of Septic Tank ..... et. #g.....'...Steel
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8. Soil Conditions: Type of Soil „•,
(Sand, Gravel, Clay, etc.)
Maximumground water table .................................................:..................................:...............................:..............................
9. If not served by public water supply: ,
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Distance from Owner's well ........................................................................
Fromadjacent wells .................................. ................................................
10. Distance to nearest water course, drainage ditch, storm drain or embankment .�5....f.t..,....fxam....i,n,gz�c�.t nd....P' j
. 11. Percolation Tests: Time for 1" drop in soil test ......ftpa r.........................................................................................................................
E° Classification of soil ...................................,........................................................................................................................................................, ., ;r•
12. Minimum square feet of effective seepage area required ........:......3.75...Bq.•.....f t.,,....................................................................
13. Leaching System: Number of trenches Qne..•(;1,)„•bed Length ........40 f t. 10 f t.
Width .......
Depth 'My.............04...fit................. Other ......... ............................ ................................................................. y�
14. Plot Plan Attached. No.... Q................................................... 4y
15. Layout Approved. .......... es............................_..................
16. This permit expires .........0.6 August,.....1.97.2.........................
Signature ..........Adam...S.,�...Wi.aniatviki.....(W.9.=206.5.�9).................................. r 1
(Licensed Drain Layer)
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Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
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................ ................. ...... 19... By ._ Y
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Pollution Problem abated Date :. �. 97 Melvin dWArclr , . . .
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