HomeMy WebLinkAboutSeptic Repair 00 king Street (2) -wow,
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Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
Fee Paid . C�aOC, By .1'A 1 ,. ; t o..33lj.:t .................................... Permit No. .. r' r.:::..'`...............................:
$.............:.................... ...
Date2......,,:.....!.,:..;......'..:.:z<:.:..............................
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein
for repair ......... or construction .wl
.;. of an individual sewage disposal system concerning which the following
information is submitted:
1. Owner of Property s'':: ? .x:nr k.....):......;!.' .t:z.(, ::f.%z.:,..s?.?address of Owner :``: ..} „
2. Location of Property ".a,.z6,. :, K- Lot No. ..............................
3. Type of Structure .................t!Kr': .I:.I ................................................................................................................................................................................................:...............
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ............. ................................................................................................
5. Number of Bedrooms ......D,'n..... ,7.)..................
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank :i..,00AC)....z; r.;S.,l,C.SaS<,......... Material of Septic Tank ..........................................................................................
8. Soil Conditions: Type of Soil ......t:>.r ssr.'1........._..............................................................................................................................................................................................
(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
,. ,, ...a;%L7,,;.t:,t.y.>. ;? ..1,.;1.r1.;.i.:::,..................................................................................
Classificationof soil ....................................................................................................................................................................................................
12. Minimum square feet of effective seepage area required .................. ' .;"....;:;.s.. .:i..n.................................................................................................
13. Leaching System: Number of trenches ................. Length ...../....w: ..... :.:%:�.................. Width .......:2..3..Y:..... :..r...................
Total .. :. :: ....4�.qr ......... Other ........................................................................................................................................................................
14. Plot Plan Attached. ........` s............................................
15. Layout Approved. ................ . ..........................................
16. This permit expires a :::.::.. u:,.. k.....:�.1 i .................................................
f ,
Signature ... ........................... .::::...............................................................
(Licensed Drain Layer)
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
A
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........................................................................................ .....:,. ,........... 19.....L.L..... By
PollutionProblem abated Date .............................................................................. ............................................................................................................................................
Inspector