HomeMy WebLinkAboutSeptic Repair 65 Hillside Drive Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT`
DRAIN LAYER'S PERMIT
Application for Permit to Install kR pair dividual Sewage Disposal System
.� ........ B .3(: „ ........................................................................ Permit No. .............. .........
Fee Paid $...........'.:...:, y ......... ,....
Date ...........................................................................
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 .......
2. Location of Property ....:..:,z ::::.......................................................................................................................................................................... Lot No. ............:.................
3. Type of Structure .............. .:::.. :s.:.....................................................................................................................................................................................................................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ........::.;.............LI..'............: .:;.?.;;..
5. Number of Bedrooms ................................................
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank ......................................................... Material of Septic Tank ....:.: i... ,;.:.........................................................
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
.................................................................................................................................... 19.................. By ................................................................................................................................................
PollutionProblem abated Date ................................:............................................. ............................................................................................................................................
Inspector
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NOTES Scale = 40, in 1" approx. SOUTH WINDSOR POLLUTION CONTROL
S T D (new) LOCATION 65 Hillside Drive
A 12.5 5.0 OWNER
B 04.5 37.5 TYPE OF WORK Se•tic Repair
DATE 06-08-72 PERMIT 72- 6 PIPE4" O.B.
INSTALLER Silvester W9-20 440)
INSPECTOR ME DRAWN BY ME