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HomeMy WebLinkAboutSeptic Repair 327 Hilton Drive ice' i "M c�u�r�t of �� in�►�lax Department of Pollution Control SOUTH WINDSOR, CONNECTICUT DRAIN LAYER'S PERMIT Application for Permit to Install or Repair Individual Sewage Disposal System s Fee Paid $ a .71 3J 7.........../.P............................. By .........t(EQ!! .... Q�.....2c17. '................................................................................ Permit No. .......................... Date ....09...J;r yfr....6.7.1........................ 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 .327...164�.T..!c .............................. 2. Location of Property WM-1 1..s UIE.....sr..4r.kj...dF....c{ .1 ?I�. /Lus ......................................................... Lot No. .............................. 3. Type of Structure ... ............................................. . ....... .................................................................................................... .................................................. ....... 4i-�-1��1: (Dwelling, Commercial Building, Store, etc.) 4. Number of Families or Persons to Occupy Premises ...0.r..Ig...44).....E11...!!APM%J............................................................................................... 5. Number of Bedrooms ................................................ 6. Average Daily Flow ................................................... Manufacturer and 7. Liquid Capacity of Septic Tank ......................................................... Material of Septic Tank,6XtS.T.1.!!/..!....0'.PN... .*7.4K................... 8. Soil Conditions: Type of Soil ............S:NN....b................................................................................................................................................................................................ (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 ....f:4P. q...................................................................................................I.............................. ............... Classificationof soil .................................................................................................................................................................................................... 12. Minimum square feet of effective seepage area required ................................................................................................................................................... 13. Leaching System: Number of trenches .)*..4...:.....4ia.............. Length ......./.,I©......0!Fr............. Width ......3 ..0 P.r................... TotalFn........ Other ......................................................................................................................................................................... 14. Plot Plan Attached. ............................................................... 15. Layout Approved. ....... ........................ 16. This permit expires .0.9 SkP..rV4!p!OF,R.,.J..9..71............................................. Signature . ....... . . .( ^.......t ./...j4,44, .. ........................................................ /� (Licensed Drain Layer) 1'YpAhl �� WLS.41C- %ACJ Cw9-:3S/%i2, Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances .................................................................................................................................... 19.................. By ................................................................................................................................................ Pollution Problem abated Date ...o. ,�sa.1,r�...�...1..9 I........................ ................... . r ... .. 4,...............................I................... Insp or N � zv 39 IS 1 Sn ' 50 i 1 1 1 I 93.5 1 NOTES SOUTH WINDSOR POLLUTION CONTROL �I mT -ro %a a t-6, LOCATION 3.2 ,L o 'Dat v e OWNER Er4iwo C. C au E TYPE OF WORK Sao a DATE 1 PERMIT s PIPE 'l INSTALLER m Z INSPECTOR Ng DRAWN BYMr