HomeMy WebLinkAboutSeptic New 00 John Fitch Boulevard (3) TOWN OF SOUTH WINDSOR
HEALTH DEPARTMENT
Application for permit to install a ne 74repair subsurface sewage disposal system. To the Health Department,
Town of South Windsor.
Fee Paid BQer Date (34d .3 Z9 7 Permit Number 9—Z
A a subsurface sewage disposal system installer licensed in the State of Connecticut, 1
4J y5;; �1ei1�r��J' s S "7-F oral 4W6 y9 7
Name, Address, Telephone Number, License Number
hereby apply for a permit to construct/repair a subsurface sewage disposal system locat d at
. ,� and owned by wit/ A)
Street, Address, Lot Number Name
Address
Information to be supplied by Applicant:
Type of dwelling R If non-residential, estimated daily flow
Residential,Commercial,Etc.
Number of bedrooms -IT Size of lot
Number of fixtures above basement
Tubs,Sinks,Toilets,Etc.
Number of fixtures in basement, if any ,
Pumped or gravity flow,
Type of water supply Cc�L�L�— If private,type of well �t
Public-Private
Information to be supplied by Health Department:
Soil type at various levels 'ra"d
Percolation rate < 5*i"b tiak . Square feet of effective leaching area required 37s—
Size of septic tank It,oo Type of system 7r s
Trenches,Drywells,Etc.
Number of dry wells, trenches, etc. z Distance between individual leaching
unitsMistance from well on same property > P7 on adjoining property
Curtain drain required h0
Yes,No
Height of system above ground water maximum ground water ,
ledge I--- , impervious soil layer
If automatic closing is required,description
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 3
Vgn.t,, f Applicant&License Number
For Office Use Only
Permit issued by Date �o�3 =
System installed by �u
Final Inspection Approval olcirls Date /I—/y—)
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WO
DATE PERMIT _2 8" PIIIZ
INSTALLER
INSPECTOR DAWN BY
N/F MALIN
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Cat' Lu
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Cowco
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O`90 co 4J
EXIST_ exisT.
Lf? 970� CHD _
ROAD _ I09.7I \ t'
JOHN FETCH BLVD. \� RIGHT TO CONNECT TO EXISTING DRIVEWkY
\ ACCESS OF MALIN TO BE OBTAINED
_ EDGE PAV'T.
x 5S
PROPERTY . OF JOHN a PATRICIA ROMAN
JOHN FITCH BLVD. SOUTH WINDSOR, CONN.
EMIL W . LUCEK ASSOCIATES
NO. REVISIONS DATE SCALE 1° = 40' DATE 3-15- 79
CONSULTING ENGINEERS
5 OAKLAND ROAD DRAWN A. V. H. CHECKED E. W. L-
SOUTH WINDSOR, CONK. _
203-644-2474
PROJECT 79-31 1 SHEET
70
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TEST HOLES
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IUWN ur- bUUTH WINDSOR
APPLICATION FOR SITE INVESTIGATION AND PERCOIATION TEST
a
nformation to be supplied by Applicant:
ame and Address of Applicant "
ocation of Propertye
Address, Street, Lot Number
ame- and Address of Ownera�,�,
ite of Lot Type of Water Supply_ /
ignature of Applicant Date
iformation to_be. sunplied by Health Department• _
ascription of Property fti-y
)il .Conditions
)servation Pit #1 Observation Pit #2 Observation Pit #3
_ g —ion �o� to to
.tO� sa.d to to
to - to to
to to to
—to— to to
of Percolation Tests:
'e s t Water Time Rate Test Water Time Rate
le # Depth Time Level Interval Drop Min./In. Role. # Depth Time Level Interval Dro Min. /In.
t I s= ?sjy
.517 3 less tofu..
/L,)h OCA
sign Rate 5_A4. Ana. Design Rate
narks
sts conducted by �. ,d—,� Date 3-01-
proved for septic system - yes i/ no
Le of Sanitarian_ Date