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Home My WebLink AboutSeptic Repair 269 Main Street �n�rn of �nn#� ind��nx Department of Pollution Control SOUTH WINDSOR, CONNECTICUT DRAIN LAYER'S PERMIT Application for Permit to Install r epair dividual Sewage Disposal System Fee Paid $................. By :.:.:;.: J : :: ::...................................................................................... 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 .................................................... Lot No, .............................. 3. Type of Structure .................... .:................................................................................................................................................................................................................. (Dwelling, Commercial Building, Store, etc.) 4. Number of Families or Persons to Occupy Premises .............s::;t+.::...'::'. '. '" 5. Number of Bedrooms ................................................ 6. Average Daily Flow ................................................... Manufacturer and 7. Liquid Capacity of Septic Tank . ::>: ..:.:: .';..::a'............................. 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 square feet of effective seepage area required ....................::',.'.;,. I..., 13. Leaching System: Number of trenches ................................................ Length ................................................... Width ................................................... Total ................................................ Other ......................................................................................................................................................................... 14. Plot Plan Attached. ............................................................... 15. Layout Approved. .................................................................... 16. This permit expires .............:.:::....:1.:: :. :.:.....::':::.:;:.. Signature .................. ........................................................................................................................................... (Licensed Drain Layer) Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances .................................................................................................................................... 19.................. By ................................................................................................................................................ Pollution Problem abated Date L...../.. !° !L i976 � /wv ................................. . . . .. y .......................................................................... Inspector � so N4s --- --- ----- ---i- - - - - - - - - - - - — J 6x�cri.r' Ss��e. A ,g NOTES SOUTH WINDSOR POLLUTION CONTROL Drawing not to scale. LOCATION 269 Main Street s_ /T IVA OWNER HARWOOD Samuel TYPE OF WORK Septic Re it 4(19 9 DATE PERMIT 6-04 PIPE 411 PvC B 2 1 1 s INSTALLER Arthur Ruff INSPECTOR DRAWN BY N w, cc i tA T't F 26q �uelk 7Rep .01 Ile i NOTES SOUTH WINDSOR HEALTH DEPARTMENT 125'd G wl>bti ?`u".lc LOCATION > OWNER 144crAA, TYPE OF WORK r a" DATE PERMET PIPE INSTALLER INSPECTOR 2.V DRAWN BY