HomeMy WebLinkAboutSeptic New 392 Felt Road camit tit #nth Mubsor
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
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FeePaid $..... ............................. By &ITOV................................................................................. Permit No. ................
C� Date ..............f.f f .............................
Pursuant to written applica`tio�, permission is hereby granted to the Licensed Drain Layer named herein
for repair ......... or construction�X,.. of an individual sewage disposal system concerning which the following
information is submitted:
1. Owner of Property /� Address of Owne
p rty ............... ... ...................I............................ ............
2. Location of Property .............Zl. .....�5.�........... . Pt..... ........................... . ..................... ..............3..��...z................... Lot No. ........ ..................
3. Type of Structure ................................................................................................................. � .. ..................................................................................................
(Dwelling, Commercial Building Store, etc.)
4. Number of Families or Persons to Occupy Premises ................................................................................................................................................................
5. Number of Bedrooms ................................................
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank .0........................... 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 ........................................................................
Fromadjacent wells .............................................................................................
10. Distance to nearest water course, drainage ditch, storm drain or embankment .......................................................................................
11. Percolation Tests: Time for 1" drop in soil test ..............................................................................................................................................................................
Classificationof soil ....................................................................................................................................................................................................
12. Minimum square feet of effective seepage area required ...................................................................................................................................................
13. Leaching System: Number of trenches ................................................ Length ................................................... Width ...................................................
Total ................................................ Other .........................................................................................................................................................................
14. Plot Plan Attached. ...............................................................
15. Layout Approved. ....................................................................
16. This permit expires ........................................... ............:.........................................................
Signature ........................ .. .................................. ............................................................
(Licensed Drain Layer)
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
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.................................................................................................................................... 19.................. By .................................... .........................................................................................................
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PollutionProblem abated Date ................................:............................................. ............................................................. ...............
Inspector
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