HomeMy WebLinkAboutSeptic New 85 Foster Road M,+
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Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT'
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
fC)... .................................................. Permit No. .....'. :::: :;:'.............
Fee Paid $................::��.a:�.'.. By ............................................................................................... ........................
Date ..".'....;: iz:....?..........".;:c'..........................
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein
for repair ...r:`.... or construction ......... of an individual sewage disposal system concerning which the following
information is submitted:
1. Owner of Property ........ A*' ...•fit ...................... Address of Owner ::.........................................
2. Location of Property 1:.. .r t t j'.....:::. ....:.,?><::.t:, ........'... ; ............................... Lot No.
l-i E_:�'C. a?,'......................................
3. Type of Structure ..................................... . ...................................:......................................................................................................................................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises .............. tf7:?: :.f...............................................................................................
5. Number of Bedrooms ......''.: ............(. :.'..........
6. Average Daily Flow ...................................................
z a ' '£ `a `" Manufacturer and /
7. Liquid Capacity of Septic Tank 1 Q--4 Material of Septic Tank 1.�)f �ffi.'... ? ..:...`'. :.. ' ...................................
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 .......:', ,:.'..:L.:............................................
Fromadjacent wells .............................................................................................
10. Distance to nearest water course, drainage ditch, storm drain or embankment .......................................................................................
11. Percolation Tests: Time for 1" drop in soil test ..........ti3s If.?'.,:...............................................................................................................................................
Classificationof soil ....................................................................................................................................................................................................
12. Minimum square feet of effective seepage area required ........................;.'.' t
13. Leaching System: Number of trenches . ... ............................... Length ...: ....... .:.....:...:... Width ...... ......... ..........................
Total .. .r'. ....". :;...F':'::........... Other .............:::"."::...........................................................................................................................................
14. Plot Plan Attached. ......... :a:.?................
15. Layout Approved. ...................................................................
16. This permit expires ::.' Inn , %.?'
........ ...............................................
Signature .: ' '.a..t� .....:'i........... '........... ,a,i ::.:M:::m :..,.:.,.r.� ...................................................
(Licensed Drain Layer)
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
.................................................................................................................................... 19.................. By ...............................................................................................................................................
t
Pollution Problem abated Date ....... .: '.. ................................................ ,
`Inspector
a
N � .
710
r�
NOTES SOUTH WINDSOR POLLUTION CONTROL
Drawing not to scale. LOCATION 85 Foster Road
S-& P jg OWNER Mrs. Frank K. D k
TYPE OF WORK Septic Re air
DATE PERMIT 7 -07 PIPE
3 +' INSTALLER 4
INSPECTOR ._ DRAWN BY 9k-