HomeMy WebLinkAboutSeptic Repair 2092 John Fitch Boulevard SOUTH WINDSOR HEALTH DEPARTMENT APPLIOAOV ?4U.
=VW=GATSOR FOR Sjp.WrAG DZ9PC8AL
ownew LOCATloa ;26,!Fd- , Z
PEl4COT =0jf TZ*,jTS: (Recoil &U. tests) !��� SOIL MOISTURE:
med., ov, e+:
TEST RFADIMS
mcu
Time Reading Time Ring Time 4*sding '!lime Reath#
/V 47V 8
j4L7
ry y� t�yy
ULATIOR OF VOT RMIULTS
it l`f 1/2 Depth Presoak Minim= .Pescolstioa ft.
(Mims. Inch)
1
2
4 .
CBSFR4ATION ?ITS: (Record all pits) _ 9(, Grcund 'dater Tsbl::
(Date) tear ;rsx. Be ov KBx.
E'�Ce'tI?�.'I(?'+�
PIT A Pn_ C PIT D
o,6 4f --lap $P l r
b-12- Cvvrfe SKI
Iz-36 Weed coL r>e ftco�
36"7 a tovl fe-f"Y suw�
J&It _- JW44�'
TASVLATMOR Or OSSFA7A ON n"S
Ground Soil.
Pit t4caticu Depa L== At Water At
A
C P
D
ev,
?=4 #2 SOUTH WINDS-Pt HEALTH -2• for ;",.age. Di�s�,�aal. Sys�
DEPARTMENT
SPFI m CONDITIONS
system design larger than 2,000 g.p.d. Waters 017 watershed
pYgh ground water (less than 4+ ft.) Possible seasonal, high
ground pater
Watercourse, marsh or pond Possible seasonal flooding
Limited suitable area Slope over ISV
Marginal soil (30 - 60 mins./inch) shallow ledge (less than 7 ft.)o�
underlying tight soil (less than 14 ft) Other
CONCLUSICIN
Suitable for sewage disposal
unsuitable for savage disposal
Additional investigation required
Retest during Bret season
r3zid is plan required_.,_,
DESIGN RMOPMCIDATIONS
-
�6"
Investigated by Title-
Confl=ed/Wi tnessed by Title
.0 COW.nts i
Bench.mark location e^,.Lewation
TOWN OF SOUTH WINDSOR
HEALTH DEPARTMENT
Application for permit to install a new/repair subsurface sewage disposal system. To the Health Department,
Town of South Windsor.
Fee Paid Date Permit Number
Asn a subsurface sewage disposal system installer licensed in the State of Connecticut, I
1 T i d i)1 Pn y �� f.�fJ�10Eh��/S t1 G rL 1. '2
Name, Address, Telephone Number, License Number
hereby apply for a permit to construct/repair a subsurface sewage disposal system located at
.7-072 J-14tir 115-Jrc Ji 'ellycli and owned by ?Oil
Street, Address, Lot Number Name
_- ___� W�KG�f.ti•��
Address
Information to be supplied by AA plicant:
Type of dwelling 3 F If non-residential, estimated daily flow
Residential,Commercial,Etc.
Numberof bedrooms Size of lot S'�� ��4-
Number of fixtures above basement
Tubs,Sinks,Toilets,Etc.
Number of fixtures in basement, if any *�s
Pumped or gravity flow,
Type of water supply /0,G 4/1,i_ If private,type of well
Public-Private
Information to be supplied by Health Department:
Soil type at various levels yo, n,T 0'A
Percolation rate Square feet of effective leaching area required
Size of septic tank Type of system
Trenches,Drywells,Etc.
Number of dry wells, trenches, etc. Distance between individual leaching
units. Distance from well on same property on adjoining property
Curtain drain required
Yes,No
Height of system above ground water maximum ground water ,
ledge , impervious soil layer
If automatic closing is required,description
I
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 &IZZ( *ZL&l Date <�
gnatu o Applicant&License Number
For Office Use Only
Permit issued by Date
System installed by Piz
Final Inspection Approval Q� Date
Engineered Systems-Pump Systems- Our Specialty
9 Septic Tanks Vacuum Cleaned
Light Excavating Portable Toilets z 0 92 J d�j y f��
1 L"00 a ti ti .Gc 0 wt�0 MO %/A,,,PIPPIN & SON SEPTIC SERVICE � 'c
37 Woolam Road
3- 1 rnh��t�5 t� Ir WAREHOUSE POINT,CT.06088
Sy0 S� i7-/�r�a (860)623-2313 • (860)875-7472 a
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SEPTIC SYSTEMS OF ALL KINDS
LIGHT EXCAVATING&CONSTRUCTION
PORTABLE TOILETS
PIPPIN & SON SEPTIC SERVICE
37 WOOLAM ROAD
EAST WINDSOR,CT 06088
DICK PIPPIN PETER PIPPIN
(203)623-2313 (203)875-7472
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