Loading...
HomeMy WebLinkAboutSeptic New 95 Greenfield Drive TOWN OF SOUTH WINDSOR r BUILDING DEPARTMENT South Windsor, Connecticut Application for Permit to Install or Repair Individual Sewage Disposal System Application No. 07 3/4 9—Z " - TO THE BUILDING DEPARTMENT: Date. U..'a 19 4— A permit is requested for repair or construction of an individual sewage disposal system concerning which the following information is submitted: 1. Owner of Property 1. _ , Address of Owner. /'� .: �. ;r.� x-3,: .• „» 2. Location of Property,, - t-� a - t'�-`x Lot. No. /o 3. Type of Structure No: of Bedrooms NW (Dwelling,Comm cial Building,Store,etc.) 4. Number of Families or Persons to Occupy Premises_. 5. Plumbing Fixtures: Water Closets _ Urinals O Lavatories «. Bathtubs_ Showers Kitchen Sinks__ Laundry Tubs Garbage Grinder Other 6. Liquid Capacity of Septic Tank `" Material of Septic Tank ( r,.,, % f r,•• 7. Soil Conditions: Type of Soil t Maximum ground water table (Sand,Gravel,Clay,etc.) 8. If not served by public water supply: Distance from Owner's well PLA4.1 d, from adjacent wells �- 9. Distance to nearest water course, drainage ditch, storm drain or embankment 10. Percolation Tests: Time for 1" drop in soil test '2•e2 Classification of soil 11. Minimum square feet of effective seepage/area required /A SJ'f 16���•� 12. Leaching System: Number of trenches Length 11asto AS Width 2, S Total 177, S' Other Signature X censed Installe ) (Sketch showing all minimum distances and other detWs'e Iu r1Mro,,/ &J9- 3 3&9'G S Permit Issued 19 L2 By—aao�� Installation Completed, Inspected and Approved A,' cr a 19 By t lr rip t .e oNfit'!`tgt :' SMwILR PA t i- a vim �Y I� C� RF-&NF/EGD Vv V y' I C THIS MAP 'TO. B$ StAiJTiAI.�t[' y tX R "-)ICCORDANCE WITH -CLA,.% Ast OF 'J' HNICAI. CUUNII, .0. Pi.h►�1 OF LAND _J►rl`:_: ;I �►DO RE��:u� �.�,�; t��s�� �,�� ��. -_z�`�-?�_e�` -moo�,�',�! wMr►otw cou*rr�r =l�� oFx�►Ms- = - -- - - - - R ►OE - lo: 1.i0�1F' :Nib:' 10�0 41T, 13i r-6 !logi c: OAAAO: LiC, t ENo�,NEE�.1me Como^Irn arm- Department of Pollution Control SOUTH WINDSOR, CONNECTICUT DRAIN LAYER'S PERMIT Ap plication for Permit to Install or ep Individual Sewage Disposal System E _ Al-z el-7 Fr- Fee Paid $.... a........................ B �'6v�in Ctn y ...........................................................:.....:............................................................................... Permit No. .....7 K.....,..............:..................,... 7fn - fir`�sge� ,tilt/ Date ............q:...a'z?`.:?..5............................... J?W,r"WG Xis �`�S Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein for repair ......... or construction ......... of an individual sewage disposal system concerning which the following information is submitted: 1. Owner of Property ............................. ............ Address of Owner ............54 ...........................................�.l................ 2. Location of Property .....90.....Q,.cvmq.!F.M.......�'........................................................................................................................ Lot No. L. ................ 3. Type of Structure ...........................01r.,I.c 16,!l ..................................................................................................................................................................................................... (Dwelling, Commercial Building, Store, etc. 4. Number of Families or Persons to Occupy Premises .................. ham ..................................................................................................................................... 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 ........................................................................ From adjacent 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 .......... ..... ..................... ...... .... .. . ... ...e- ............................................................. (Licensed rain Layer) Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances . ......a.1.................................................. 19.2 t.,.. By ..................P1.1-v............ ! ��Y Pollution Problem abated Date ................................i.................................."........ ...............!�`....0 ............�.r. .............................._...... ......... Inspector Y �owx �rco�r) k i ,t yv NOTES SOUTH WINDSOR POLLUTION CONTROL oec�e -�w a eXts�1�S LOCATION 90 Greekv(lelcl Dr Lvf V 62-1 .�hr,, as b�cav3� o R OWNER TYPE OF WORK ac t ►n -or— Ws Pobl ' DATE /� PERMIT PIPE INSTALLER V+ o�' INSPECTOR (1A DRAWN BY WAT E.fit • GAS. Fk PAVED : ST. 62. 1 00 2 - - �2 . �:,� /'2ti •ter►�r���►.r�rs rs s�+41+ Cl) 4 29.D0 o . R�Zo;� _ too.00- W/t�lE�: JRMES M14.KJX BUIILL>E-,Rlr P�.A , OF. i..AlVD AT _ EAI F1 ELD . - . LoT 6z.1 �RL ADmRF_ tStGLL/VAN A v ,So. wlVD.TOP -Comm. _.w O• INDSoR CONN- DATE: E1c'7, J Q F g SCA4..� j HAMPDE.r+ COUNTY BOOK OF PLANS: --- —=-- _�=- -- - - SNPYrH LOT NO: rp.� / - II BOOK - - Mays. t.tc. i�o ENGINEERING C.O ¢a�svtY i vim.' - — - = 5�94- b0� WHITE a TOWN OF SOUTH WINDSOR HEALTH DEPARTMENT Application for permit to install a new cpai subsurface sewage disposal system. To the Health Department, Town of South Wirkdsor. Fee Paid Date r76-79 Permit Number '29-9 As a subsurface sewage disposal system installer licensed in the State of Connecticut, I Afq.yw�j -4E:IRC-e__ non,rr s .a ota u I Name, Address, Telephone Number, License Number hereby apply for a permit to construct/repair a subsurface sewage disposal system located at �.�(%idFFN F�p �� i and owned by wAz© ( n i^Z Street, Address, Lot Number Name ,1'0 6n 6 Address Information to be supplied by Applicant: Type of dwelling tS' � t i If non-residential, estimated daily flow Residential,Commercial,Etc. Numberof bedrooms Size of lot Number of fixtures above basement 6 Tubs,Sinks,Toilets,Etc. Number of fixtures in basement, if any f , `� � Pumped or gravity flow, Type of water supply / �. f 3 J_ < <, . If private,type of well Public-Private Information to be supplied by Health Department: Soil type at various levels ���a Percolation rate Square feet of effective leaching area required Size of septic tank N t l nx Type of system o%y c'-'e& Trenches,Drywells,Etc. -Number of dry wells, trenches, etc. Q3' 1hgPx 2j eviDAk. Distance between individual leaching units. Distance from well on same property on adjoining property Curtain drain required Yes,No Height of system above ground water maximum ground water ledge , impervious soil layer If automatic closing is required,description A PLOT PLAN INDICATING LOCATION OF PROPOSED STRUCTURE, WATER SUPPLY, SEPTIC SYSTEM, EM- BANKMENTS, WATERCOURSES, PROPERTY LINES AND ALSO INDICATING EXISTING AND PROPOSED FINISHED GRADES MUST BE SUBMITTED BEFORE THIS PERMIT CAN BE ISSUED. THIS PERMIT IS NOT TRANSFERRABLE FROM PERSON TO PERSON OR FROM PLACE TO PLACE. NO PART OF THE SYSTEM SHALL BE BACKFILLED UNTIL IT HAS BEEN INSPECTED AND APPROVED-BY-THE SANITARIAN. SPECIFICATION AND REQUIREMENTS AS STATED IN THIS PERMIT MUST B �AN`YCHANGES MUST BE APPROVED BY THE TOWN SANITARIAN BEFORE FINAL APPROVAL WILL BE GIVEN. THIS PERMIT SHALL NOT BE CONSTRUED AS PERMISSION TO CREATE A NUISANCE CONDITION NOR IS THIS SYSTEM GUARANTEED BY THE HEALTH-DEPARTMENT. Ad Qao fq 7 Permit Received by % Date Signature of Appli#gnt&License Number For Office Use Only Permit issued by Date Y6 7 4 System installed.by Final Inspection Approval e Date r I i 1 N W 0 ir/ing n ' r r r� ,a v a b tA NOTES SOUTH WINDSOR POLLUTION CONTROL LOCATION S 6�-, c 'P Id Dr, OWNER !7cA,aI . - o Rbs TYPE OF WORK R a Y.. DATE T-6-�q PERMIT79- 2 PIPE INSTALLER Lcv Ac - INSPECTOR P ,D . DRAWN BY G' APPLICATION FOR SITE INVESTIGATION AND PERCOLATION TEST information to be supplied by Applicant: Name and Address of Applicant Location of Property, Address, Street, Lot Number Name' and Address of Owner Site of Lot C- Type of Water Supply` Signature of Applicant Date_ Information to be supplied by Health Department: Description of Property. Soil Conditions: Observation Pit #1 Observation Pit #2 Observation Pit #3 D to S 61-C SA-1E., 15'-jt to to r T s to a nzd'5'e�d to —to- to—- to to to to to to to to Log of Percolation Tests: Test Water Time Rate Test Water Time Rate Iole #. De th Time Level Interval Drop Min./In. Hole Yk Depth Time Level Interval Drop Min./In. Design Rate Design Rate Remarks pe-na-A ' 4ca e?cy,.5�4_i Tests conducted by_ l®�� �, Date Approved for septic system - yes no Signature of Sanitarian ,OPTS Date l t s z�