HomeMy WebLinkAboutSeptic New 2589 Ellington Road aliatutt fit OLIW4 Ightboor
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT"
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
10.00 Check....N..1 b. ...1. 23.................................................................................... Permit No. 23m66........................................
Fee Paid $.................................... By ... . .
Date 1.3...Homo lbex..,.....19.7.3...............
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein
for repair 7C)C.. or construction ......... of an individual sewage disposal system concerning which the following
information is submitted:
L Owner of Property .............Ernest. ..R......Jacobsen.................... Address of Owner ....2.`a.89..P4i gton,,.Road,,,.,.,,,,,,,,,,,,,,,,,.,,
p ............. . .
2. Location of Property ..... autte........................................................................................................................................................................ Lot No. ...........2...............
3. Type of Structure ............... welling.................................................................................................................................................................... .
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ..........One. (.1)....family................................................ ..........................................
5. Number of Bedrooms ................................................
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank1..,.10.0....01.10AM........... Material of Septic Tank .. ,1..ate,n8...-....Gt?ncxete..................
8. Soil Conditions: Type of Soil ..............................................................................................................................................................................................................................
(Sand, Gravel, Clay, etc.)
Maximumground water table ..............,.............................................................................................................................................................
9. If not served by public water supply:
Distance from Owner's well ........................................................................
Fromadjacent wells .............................................................................................
10. Distance to nearest water course, drainage ditch, storm drain or embankment .......................................................................................
11. Percolation Tests: Time for 1" drop in soil test .......Repair.................................................................................................................................................
Classificationof soil ....................................................................................................................................................................................................
12. Minimum square feet of effective seepage area required ................37.S...sq...ft..................................................................................................
13. Leaching System: Number of trenches ...........2'N.Q. ..(2)............ Length ............1.28 .f t................. Width ............3.0...X t...,..............
Total .384....eq....ft............. Other ..Vart.s....Qf...o7.,d....fi.eld.....................................................................................................
14. Plot Plan Attached. ......Yee.....................I.......................
15. Layout Approved. .............Ye ............................................
16. This permit expires .......... .3...Jarn..uatz."Y...a....1.97Y...............................................
SignatureV,......\--0 ........A-L .................................................................
(HDmeown@r1\J(KMhXXKnMKXXW
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
.........................:.......................................................................................................... 19.................. By ................................................................................................................................................
v �p � dwards �Jr.
Pollution Problem abated Date ...."j.4..N�....ender.�.....�.�7',�.............. ..............................................................�...........................................................................
Q 1400 Inspector
� V
t3
441
NOTES SOUTH WINDSOR POLLUTION CONTROL
Scale: 1" = 40' approx. LOCATION 2589 Ellington Road (Lot Z)
S T OWNER Ernest R. Jacobsen
A 30.5 TYPE OF WORK Septic Field Re air
B 32.5 DATE 11-14- 3 PERMIT -66 PIPE4" P.V.C.
INSTALLER Homeowner
INSPECTOR ME DRAWN BY ME
c
FEE •
TO THE BUILDING DEPARTMENT
Application No,
TOWN OF SOUTH WINDSOR Date ^212
I hereby apply for permit to build a sewage disposal system for a
(Residence , boarding house, hotel , etc.)
J14�,6-&6,%/
Owned by a T . r3� ; i d , of //t�,5 7
And located a
To be built by f of
in accordance with detailed information stated below,
Signed
(App i nt)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GENERAL INFORMATION
I . Estimated population of premises (present) (future) .
2. Description of premises (including number of bedrooms)_
No. Fixtures
(Above basement): Water Closets 7 Urinals Lavatories_ Z
Bath tubs Showers — Kitchen Sinks_ _Laundry Tubs —
Garbage Grinder t---- List basement fixtures —
3. Water Supply 61-IL"(-� i„ Kind of Well
(Public, well, spring, cistern)
Location of well and underground water piping
Method of obtaining or storing supply
(Pumps , tank, etc.)
4. Character of soil at proposed location of leaching system, including depths of
various strata 1-jell ll- ,
(sand, loam, clay, hardpan, rock, etc. --Use test pits,)
5. Elevation of highest ground water_ ��, k,_,�
(with reference to both present & future grade)
1
V
Description of proposed system (Furnish drawings of same , with plot plan showing
system including location, size, grade and material of house sewer and locations
of ground or surface water drains , wells and bodies of surface water.)
Septic Tank
Dimensions Capacity below flow line I �
Inlet and outlet arrangements V-<- s
Facilities for cleaning - Distance from dwellings on same
property 3 S` on adjoining property D- 'SS
Automatic Dosing Apparatus , if any (describe)
Soil Absorption System
If cesspools , No. diameter ft.; depth below inlet ft.
If tile field or leaching trenches , total length is / ft.
Width of trenches 2-- ft. , depth of broken stone or screened gravel / ft..
Stone or gravel will be covered by �7` 14 Distance between
(tar paper, sat hay)
trenches /o ft. Distance from water supply on same property
on adjoining property
Secondary Treatment, if other than soil absorption.
Describe in detail and locate on map
System was designed by
Above information furnished by
No discharge of sewage or sewage effluent into any watercourse should be permitted
without approval of the State Department of Health and State Water Commission.
i