HomeMy WebLinkAboutSeptic Repair 90 Main Street t., _ e .. - e... .. .:.'a — • .. — flu.
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Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install o epair dividual Sewage Disposal System
Fee Paid $ .... By ' Permit No...................................
Date'............::....................... ....................................
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
2. Location of Property ..............:..........::.........:.....::.: ...!.:........................................................................I............................................................ Lot No. ..............................
3. Type of Structure ..............:::.i:.;,,.,,;:..'..,........................................ ...........................................................................................................................................................................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ............::. :..... ......'.............:..:..............:..............................................................................................
5. Number of Bedrooms ................................................
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank ......................................................... Material of Septic Tank .....:::`:::?..;.................;.......................................................
8. Soil Conditions: Type of Soil .............................................................................................................................................................................................................................
(Sand, Gravel, Clay, etc.)
Maximumground water table ..............................................................................................................................................................................
9. If not served by public water supply:
Distance from Owner's well ................................................
Fromadjacent wells .............................................................................................
10. Distance to nearest water course, drainage ditch, storm drain or embankment .......................................................................................
11. Percolation Tests: Time for 1" drop in soil test .......'..:.:....:.......::...,.:.::;........................................................................................................................................
Classificationof soil ....................................................................................................................................................................................................
12. Minimum
13. Leaching System: ..e...a'1'.hx'e�....�3� ... Length
:::.......::...........:..,..................................................................................................
squareseepage required
gY g ...........1.40....feet........... Width .............................:.....................
Tota1420...sq..:.:..f t.t........... Other .7.5O....9911on.... Y....welL................................................................................................
14. Plot Plan Attached. .....:.:.:....................
.......................
.......
...
15. Layout Approved. ...........Yes.............................................
16. This permit expires
17. Reference Pollution Complaint 14-72.
Signature .......................................... ................................................................. ...................................................
(Licensed Drain Layer) '
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
..................................................................................................1.9..Ju1y,,......... 19...........7..2. By ............fi4JL........................................................................................................................
PollutionProblem abated Date ................................:............................................. .........................................................................................................................................
Inspector
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NOTES: Scale = None SOUTH WINDSOR POLLUTION CONTROL
S T DIW LOCATION 90 Main Street
A 12 00 OWNER Paul N. LaFrance
B 15 52 TYPE OF WORK Se R
C 00 59 DATE 07-19-72 PERMIT 72-5 PIPE " O.B.
INSTALLER Slater (w -2064 1)
INSPECTOR HWL DRAWN BY ME