HomeMy WebLinkAboutSeptic New 632 King Street Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT"
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
Fee Paid $.................................... By ST.A. W..A..9...Y..........K.r{.A,T.. .! .5.X.X............................. Permit No. ....................
Date .......1.,1v4..,/....2%.......................................
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein
for repair ......... or construction ...X.. of an individual sewage disposal system concerning which the following
information is submitted:
1. Owner of Property .....ST A.y9.........K.R.4i..14---.w... F,.VA-.. Address of Owner .......(s..3.2.......Zrt.w..�. .........5.�..>�
2. Location of Property ..........................................r................................................................................................................................................. Lot No. ..............................
3. Type of Structure ........:1-2 W.9.L.k.t.K.T..�...........................................................................................................................................................................I....................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises .............. . ..............�...).........................................................................................................
5. Number of Bedrooms .........3.................................
6. Average Daily Flow ..........0,5U 0,50..............
Manufacturer and
7. Liquid Capacity of Septic Tank ........l..o` .-0................. ateria f Septic Tank .........L�..O. Sr.IZ .. ...e.................................
8. Soil Conditions: Type of Soil ..........................�.!�k..�l.f.. ........ ......
(Sand, Gravel, Clay, etc.)
Maximumground water table ...............................................................................................................................................................................
9. If not served by public water supply:
Distance from Owner's well ...............7..45 0...}...........................
From adjacent wells ........................................r.`................................................
10. Distance to nearest water course, drainage ditch, storm drain or embankment .......................................................................................
11. Percolation Tests: Time for 1" drop in soil test .................... ..:..`.......... ►,............�.t. ,...............................................................................
Classificationof soil ....................................................................................................................................................................................................
12. Minimum square feet of effective seepage area required ..................3. 5........ � .....................................................................
13. Leaching System: Number of trenches ................................................ Length ................................................... Width ...................................................
................
Total ................................................ Other .........................................................................................................................................................................
14. Plot Plan Attached. ...............................................................
15. Layout Approved. ....................................................................
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 ................................................................................................................................................
PollutionProblem abated Date .............................................................................. ........................................................................:..................................................�...............
Inspector
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NOTES SOUTH WINDSOR POLLUTION JCONTROL
LOCATION
OWNER a 1
TYPE OF WORK
DATE - PjfkMITAFZZj PIPE N cz
INSTALLER
INSPECTOR DRAWN BY
iZutuYt of Ovnt4 Vinboar
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
!-O O b b y U 01 Q �L� .]
FeePaid $.................................... /............................... ................... ....... ....................................................................... Permit No. ........... ....................,....................
Date . ...". . ..'.. .. ...............................
Pursuant to written applicatio 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:
Kji1. !�v
Owner of Property .........�.1XI..f....... ... r.3 C..�l. . 1.�......... ddress of Owner .......4..-67
.................... ... :............................
2. Location of Property - .... !n. .........�.�........................ ........................................................................ of No. ..............................
3. Type of Structure..s� ?!.!? ... . ...:...r•............................................... //?.... ........................................................... ......................................................
(Dwelling, Co mercial B�iilding, Store, etc.
4. Number of Families or Pers ns to Occupy Premises .............�m..........................................................................................................................................
5. Number of Bedrooms .......................................
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank :.................... ...............:........... Material of Septic Tank .......................................... a
8. Soil Conditions: Type of Soil ..........................�alr?.
(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 .............� .. ../. ."l...r................................................................................................................,..............
Classificationof soil ....................................................................................................................................................................................................
12. Minimum square feet of effective seepage area equired ...............................z................... . . .. .. ........................... j
13. LeachingSystem: Number of trepches ...................".. ..................... Len thST.. ......,�
Y e ... g V.
f� �Width ....,..1..........................................
TotalZG...... ....................... Other .........................................................................................................................................................................
14. Plot Plan Attached.
..............................................
15. Layout Approved. ...... ....... .........................................
16. This. permit expires ............................................................................... ..................................
. r
Signature 'Utn. ... !r?. .... ...... .................. ....... . . ............................ ....
(Licensed Drain er)
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
..'.................. ..................................................... 19 ,/..... By ................ ...................................................................................................
GC.tfe�
Pollution Problem abated Date ................................:............................................. ........................................:.............. ........................................._...............
Inspe or
TOWN OF SOUTH WINDSOR
TOWN HALL
SOUTH WINDSOR, CONN. 06074
DEPARTMENT POLLUTION CONTROL
Date 4-,/:7 7 . . . . . . . .
The Sanitary" Sewer . . . . . . . . Septic System .!1.. . . . . .
at . . . . . . . . . 2 l /has
. . Gl D`'. . . . . . . . . . . . . . . .
or lot #. . . . . . . . . . . . . been installed and completed
in accordance with the Town of South Windsor ordinances
and regulations.
Accepted ° Approved
By /I C '�P✓ Date �/