HomeMy WebLinkAboutSeptic Correspondence 501 Griffin Road :;: :,' SOUTH WINDSOR HEALTH DEPARTMENT APPLI"A- ?4U.
=V==GATICR FOR SEWAGE DMVI OSAL SY71", Rl cx-i h
Oar LOC.ITION rod Sri
PBACOTATIOA TESTS: (Record all. testa) �? SOIL MOISTURE:
Date ga, med., ov, eu
TEST READINGS
HOLE #1 SUI.S #2 Isca #3 DOLE ,
Time Read'"m Time Reeding Time 4esding Time Readizu
TABUTATIOR 0P TZ'WT ? LITS
Depth pr,.s �==M .PercolAtioa Rase
Hole tomtIon (Inch ss) Era. (Mina. Inch
2 'd
3 acs •
C SMATIZON PM: (.Record all pits Ground Water Table
Ds *test ;!S7C., Be ov Kea . a
0FScRIP'!'I0N-0
F= A PIT B PIT c I FIT 0
O _(, "7`0� Foil V-6 7'*O
- ,fai/ r
cav/�� SUµd 6 32� — Lav/S�St�r+o�
3.1—!4 turd 7La
r4VJ fa441 co L rae fa.wd
.�. v 6,L✓ iv.o G.1n• , Lrdir-1 V.- '
nv o /vivd`�lC ,�yla dr n�
TABMATION OF 08yPR"lAnOR P TS
Ground sou
Pit Locsticit nth . Lad_6* At Water At Me-Alin;
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FORM 2 SOUTH WIN S 0 R HEALTH •2• Investi&At ou_for :cage• Disposal. Sysz•
DEPARTMENT
SmIlm- IAL CONDITIONS
iZrst&m desigi larger than 2,000 g.p.d. Water supply -watershed
Elgh ground Water (less tbaa 4+ ft. ) Possible seasonal high
ground Water
Watercourse, marsh or pond Possible seasonal flooding
Limited suitable area Slope over IS%*-
Marginal soil (30 - 60 mina./inch) shallow ledge (less than 7 ft.)
underlying tight soil (less than 4 ft)_ Other
CONCUM108
Suitable for savage disposal.
unsuitable for sewage disposal
Additional investigation required
Retest during Wet season p
maser s plea required Qr,,Jd
DESIGN RECOVI-M ►TIONS e
Investigated by Title
Contizmed/Witnessed by Title
Commeats:
3each.mark location Elevation
- PROPERTY OF V, _..
RONALD• !Z. f, . ATHRYN M. COLLI'V
'. 501 GRIFFIN ROAD �
SOUTH W I NDSOR CO`:;rC..T'I CII.r
SCALE . I" _ � � � r'.i:� i:IE Z6 1975
t
I
: IK
(14 322 a
.47 ACR£S
\
s��.
• [fart ford' "
Federal Savincts
..f�r'•_' Ronald _R o Collin.,..et al_ �
- .� _i,i i � }•i�3- �tr _G dt Y•a !' �:tivt_i/)y:�v
67
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 Wind or.
Fee Paid / �65 � Date7 Permit Number
As a subsurface sewage disposal system installer licensed in the State of Connecticut, I
nlcharb Plps"'-i 32 "1001g•+'Rb et/-ldhd' &23 27/3 1061
Name, Address, Telephone Number, License Number
hereby apply for a permit to construct/repair a subsurface sewage disposal system located at
COI Csr,,,_11evv,,r Rb S t,✓ and owned by
Street, Address, Lot Number Name
Address
Information to be supplied by Applicant:
Type of dwelling 63 62 19�*"a17 If non-residential, estimated daily flow
Residential,Commercial,Etc.
Number of bedrooms J Size of lot '17ar
Number of fixtures above basement
Tubs,Sinks,Toilets,Etc.
Number of fixtures in basement, if any ,
Pumped or gravity flow,
Type of water supply A'Jir5R If private,type of well Q1't /��
Public-Private
Information to be supplied by Health Department:
Soil type at various levels _
Percolation rate Square feet of effective leaching area required y95
Size of septic tank /e06 Type of system %
Trenches,Drywells,Etc.
Number of dry wells, trenches, etc. 3V 5-� . Distance between individual leaching
units. Distance from well on same property 767 on adjoining property
Curtain drain required
Yes,No
Height of system above ground water maximum groundwater ,
ledge , impervious soil layer
If automatic closing is required,description
I
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 Date
Sign a of !cant&Llcens umber
For Office Use Only
Permit issued by Date
System installed by
Final Inspection Approval Date �j'2-7 27
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NOTES SOUTH WINDSOR HEALTH DEPARTMENT
ht4 f' S� � LOCATION not r2.,; oq-Tm
OWNER
TYPE OF WORK p,•r
DATE-Y-
3ofZ7 PERMIT PIPE
INSTALLER
INSPECTOR Rb DRAWN BY- ��