HomeMy WebLinkAboutSeptic Repair 70 Hilton Drive i!
Teton of On* 18inbsor
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT J�
DRAIN LAYER'S PERMITS"!
Application for Permit to Install or epa' Individual Sewage Disposal System
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Fee Paid $...to...................... By ....f'tv.q.m..................w.f.S..N1.'cw g1<./....................................... Permit No. ....��`..'��...........................
Date . )r ..�o.... ...�a..............
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein
for repair :..K or construction ......... of an individual sewage disposal system concerning which the following
information is submitted:
1. Owner of Property ...............W,..... .......... .►Z.11t.rrk,t?............. Address of Owner ....:1.9......../ .'TQI I..........ilpJk�.........................
2. Location of Property ..........I ............./9/..!TQ Av.............7g..j..V ................................................................................ Lot No. ..............................
3. Type of Structure ......................P.V 11�J-1..46....................................................................................................................................................................................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises .............O.i.�l.-a.......... ............................................................................
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 ........................................................................
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 ..................................................................................................................
J.1 Signature ....A4(--dL#V-V-1....... .1111�-Iltvvk.........................................................
(Licensed Drain Layer)
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
.................................................................................................................................... 19.................. By ................................................................................................................................................
PollutionProblem abated Date ......... ..............I........................... ......... ....... .... . ,.... ........ ... ....._...............
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION O 47-,*At
OWNER �T. A NDJ-P
TYPE OF WORK ev ric- Trrn 'R CPAi
DATE S'•2G• 78 PERMIT PIPE
INSTALLER 612gm W IS N)C W SY-1
INSPECTOR DRAWN BYml