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Home My WebLink AboutSeptic Correspondence 389 Griffin Road FORM#2 State of Connecticut Department of Public Health APPLICATION NO. INVESTIGATION FOR SEWAGE DISPOSAL SYSTEM Owner r J f�,vcc�t fot Location 6 rr7 PERCOLATION TESTS:(Record all Tests) `1 O SOIL MOISTURE: (Date) (high,med low tc.) TEST READINGS . -HOLE HOLE HOLE HOLE Time Reading Time Reading Time ea g tme ea ing v TABULATION OF TEST RESULTS Hole Location Depth Presoak Time Percolation Rate OBSERVATION PITS: (Record all pits) Groundwater Table (Date) (Near max.,Below max.,etc.) SOIL DESCRIPTIONS PIT PIT PIT PIT 0- -ry p p 7�wtid f�,d TABULATION OF TEST RESULTS Pit Location Depth Ledge Ground Water Mottling 1/1/00 49 e+ a PIPPIN & SON SEPTIC SERVICE 2 y S►pn�at 7 f 6 ✓�f1n 7 00 o 2 G 0�� f�� (860) 875-7472 3 a y �,r► Tr'K nG /�` r q�i,,��P�.� w, r-vI fcr, (860) 623-2313 10 -y ry /4, Gcolll( J � a 5z-H Yo G SCR o ----------------------------- ----------- 'Af r oo } �3, � PIPPIN & SON SEPTIC SERVICE Svvo,a 7 f 6 #1 (860)875-7472 3�'9 (,-�� nd ��, (860)623-2313 , -7 wit S,,H Yo ------------------- --------------------------- 7o � s TOWN OF SOUTH WINDSOR HEALTH DEPARTMENT Application for permit to install a new/repair subsurface sewage disposal system. To the Health Department, Town of South Windsor. Fee Paid Date 01/- 1f-O Y Permit Number As �ja subsurface sewage disposal system installer licensed in the State of Connecticut, I �k C N a r h Y if u Olo b'" 37 &^ "a 6 l a ws AA /_S!6s i &A3 -2-3 f 3 1(4 6I Name, Address, Telephone Number, License Number hereby apply for a permit to construct/repair a subsurface sewage disposal system located at 382 !1i ,T 1l and owned by �S •,�-a�+s Street, Address, Lot Number Name Address Information to be supplied by Applicant: Type of dwelling as OV If non-residential, estimated daily flow Residential,Commercial,Etc. Number of bedrooms Z Size of lot sic P/4✓/ Number of fixtures above basement / Fay,// 6 %h 4- `,-rck ca Tubs,Sinks,Toilets,Etc. Number of fixtures in basement, if any Az"s he,.- , n Pumped or gravity flow, Type of water supply +�/C!� If private,type of well �vr� Public-Private Information to be supplied by Health Department: Soil type at various levels „CPC re s i or/a- Q fi -Far Percolation rate / —l0 Square feet of effective leaching area required 3 7 Size of septic tank L00 0 `/611-reType of system Gal/a✓ 4/;3 r Lo.� Trenches,Drywells,Etc. Number of dry wells, trenches, etc. y3 —r';�&,0,2 Distance between individual leaching units. Distance from well on same property !2 on adjoining property Curtain drain required Yes,No Height of system above ground water maximum ground water , ledge JAn)ae , impervious soil layer I, 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 BE MET AND ANY CHANGES 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. Permit Received by UADate 0 ignature of Applicant&License Number For Office Use Only Permit issued by Date System installed by Final Inspection Approval Date • �._...,...........,-..._.�..........--............_......_....�....... .. ..... ...•..w_..•,. ...�..-....w+ .r.., ....•.......w..,..u..n......w.,•..n+e u>M.n,•., ,,........-•..•w,.•,,..,. ..,........, .. ....�,+' .. ,. •.s+........ .�,..-,.a � ........,...,,.,. o.. .... .....,...,.,..,.<. t ` s .£ Q4 \ . r � Z 4,h ` th • �;� � . . ' ��, � �;.� `� apt�; � s .. .,.�.u. ... .....,.. -. .� ., ....a... _ .,,..a•..,,�.....r,._.>.,..w....., •�.....n..........,....w......,�...«.,.......e.•...w«...Ww..., ,.v.e..........�...«....u,w...w.n...u.+�... ... ...... ,.... 7, ° Of 0114 Ightboar Department of Pollution Control SOUTH WINDSOR, CONNECTICUT DRAIN LAYER'S PERMIT Application for Permit to Install or Repair Individual Sewage Disposal System aHeall rlo, 2090 ... Fee Paid $.....;.::.::....:..:................ By ..................................... ............................................................................ Permit No. .......k.r..::...=� Date .......... ......................................... Pursuant to written application, permission is hereby granted to the Licensed ', n Layer named herein for repair .,..,::. or construction ......... of an individual sewage disposal system concerning which the following information is submitted: 1. Owner of Property �:i.. i t.:a.r.. .::.....,:f....r :. . �..,;.:;f .......... Address of Owner ......r..; :...,:.:.� ....:: . ' ..... 2. Location of Property rJ:.:�....,; �.....::,. .,.:..,F :.... 5....t .'4..t.:.::,::�r.::........................................................................... Lot No. .............................. 3. Type of Structure .......,..'::�<.i.r::s:.t.a..�r ...................................................................................................................................................................................................................... (Dwelling, Commercial Building, Store, etc.) 4. Number of Families or Persons to Occupy Premises ....X i ....,.. +:...,.:. r.::.. ..::f..... 5. Number of Bedrooms . ':¢�'� . : ....f... , ......•.• 6. Average Daily Flow ...................:'.....................I....... Manufacturer and ,. 7. Liquid Capacity of Septic Tank;:...'a...i ...- ,-...4,.,::ast.. .... Material of Septic Tank/.G; <."..&�•''.-.. ...::.... :.......... :....... 8. Soil Conditions: Type of Soil ..............:: :> r.. . ............................................................................................................................................................................................ (Sand, Gravel, Clay, etc.) Maximumground water table ............................................................................................................................................................................. 9. If not served by public water supply: Distance from Owner's well .............. ::.....=:..z.:......a>�;::�... ............ Fromadjacent wells .:.:.:: .;::.<..::....................................................................... 10. Distance to nearest water course, drainage ditch, storm drain or embankment ......Ys: :::%:........:°::..................................................... 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 4-.-,:.3......... ..v,.a :a„, ...:.>.rr... f:..... .3: ................... 14. Plot Plan Attached. .....Y. S.............................................. ... 15. Layout Approved. ........... .r.............................................. 16. This permit expires Signature ., ...'........ . ........... ................................................................ (Licensed Drain Layer) Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances .................................................................................................................................... 19.................. By ............................................................................................................................................... Pollution Problem abated Date ....1. ....Jul r....1.911................... f� ... . J �� "` r In4pecto N --, i � O oy l7' O Or yS� / Qum-efF ro a,toox NOTES SOUTH WINDSOR POLLUTION CONTROL LOCATION 389 faiFr-tom Rohjk A 8 OWNER lZat4mai A. G / 29 4l, S TYPE OF WORK Sf 2. 24.S '24 DATEg2ZZsAj PERMIT?/-3 6 PIPE INSTALLER 4oAA4 -k) INSPECTOR E DRAWN BY