HomeMy WebLinkAboutSeptic Repair 80 Hilton Drive Omit of *nut4 Ightboor
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install or(
r Repa Individual Sewage Disposal System
FeePaid $..................:. By ........: ....... ..;........ ........................................................................................ Permit No. ......................................
Date ......'r...M 177..:4.....................
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 . :: ..:.`..>. ..... m............................ Address of Owner ..... .... . . :.:........................................
2. Location of Property ...............: .::........................................................................................................................................................................ Lot No. ..............................
3. Type of Structure
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ..........................,.:�:. '` : ?.;: '°
:.:... :.. ........................................................................................................
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 ........ i__.., ........................................................................................................................................
Classification of soil ..................................... . . ..... .
12. Minimum square feet of effective seepage area required ............... j,5-;..........::.;....:.......I......................
.................................................................
13. Leaching System: Number of trenches ....I-We:.«.3.................. Length .....".7...F7....................... Width ............31.p...FT...............
Total .....10....159.4�............. Other ........................................................................................................................................................................
14. Plot Plan Attached. ...........;....................................................
15. Layout Approved. ..............YCS..........................
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 ..........!s�A? � r .................................... Imp ........................................ ...............
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NOTES SOUTH WINDSOR POLLUTION CONTROL
Drawing not to scale. LOCATION 80 Hilton Drive
3 -r 13 OWNERPICARD J h'W.C.
�q 7,sf TYPE OF WORK Se tic Repair
35,41 ,37, s' DATE os la w, PERMIT 6-12 PIPE,?1'AV,C,
INSTALLER Pi in (S.I. # 001061)
INSPECTOR DRAWN BY
r
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Dispos ystem
Application No. /
TO THE BUILDING DEPARTMENT: Date 19
A permit is requested for repair or construction of an individual sewage disposal system concerning whit the
following information is submitted• f}
1. Owner of Property . � —Address of Owner V
C�
2. Location of Property Lot. No. O�-
3. Type of Structure No. of Bedrooms 3
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories 2 Bathtubs
Showers Kitchen Sinks_ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well 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 Classification of soil
11. Minimum square feet of effective seepage area re uired-,- _
12. Leaching System: Number of trenches Length; Width Total
Other
Signature i
(� )
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By