HomeMy WebLinkAboutSchool Repair 81 Farmstead Drive fV
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Department of Pollution Control p
SOUTH WINDSOR, CONNECTICUT t
DRAIN LAYER'S PERMIT '
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Application for Permit to Install or Repair Individual Sewage Disposal System
' 1C) C;C Maeke.l Check No. 4502 ......... Permit No. .29n?4.......................................
............ ..... .,
Fee Paid $..........�........................ By .... . ................................................................................................................:.............
06 Apr �Date ...... ... :..:.....:T....�..
Pursuant to written application, permission is hereby granted to the Licensed.Drain Layer named herein
for repair ':Qx or construction ......... of an individual sewage disposal system concerning which the following '
information is submitted: ti
1. Owner of Property ..............
...........`!hMan.Xi.Zlxom.. ................................ Address of Owner ........8.:1....Fa;rmntpad....Dl:'ix,. ..:......
• 2. Location of Property ............................................................................................................................................................................................. Lot No. ..... .........
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3. Type of Structure ..........................................s..................................................................................................................................................................,........,........................:....... . -
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ..... 4ne (1) f ami am...ly
. .
5. Number of Bedrooms ................................................
6. Average Daily Flow ...................................................
Manufacturer and
�. 7. Liquid Capacity of Septic Tank ......................................................... Material of Septic Tank ..................................................................................,. ....
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 75 f.e.at..........................................
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...yrnrk................................................................................I................I.....
Classification of soil
12. Minimum square feet of effective seepage area required ...................................................................................................................................................
13. Leaching System: Number of trenches ................................................ Length .................................................. Width ................,..................................
Total ................................................ Other ........................................................................................................................................................................
14. Plot Plan Attached. .......1 0................................................. a
15. Layout Approved. ....................................................................
16. This permit expires fit; Jw2e, 1972
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` Signature %
Xo insPQc��or1, gn ....................u...�.... .... ......... .,..�I:.4i..:-4�.r.•a.�,,.....:.............�.............,.......,,....,............................. ..
Vita Y� Coven (Licensed Drain yer) '
(u9-2a59?4) .:
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Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
.............................................. 19.................. By ......................:.....:................................... ....... .. ..:................................
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Pollution Problem abated Date ................................:........................... ... y
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