HomeMy WebLinkAboutSeptic Repair 272 Main Street SOUTH WINDSOR HEALTH DEPARTMENT AF'PLIOA=011 50.
13Y GATICR ?'CJR SMOZ DISPOSAL SZSM V-4
pgg;pi,�►TIOIf TF�'T9: (Record all. tests) SOIL MOISTMIE:
Data v m4d4op 10vt etc
TEST Rnmms
aa�.8i #2 acZc^ 3 .
Time ReadSag Time Reading Time Fading '!`ime Readinu
IN/c! �= l6 �� •
sl Z -
03
=rY
TA3MA=(X. Cr TWT RMULTS
minimum .Percolation V.Ste
DeptA sask (Mims./Itch)
3014
Location
2 -
3 -
4
�FRPA' ITS: (Record all pits) Ground ',meter Tablet
.ION F
;dear Xxx., To ev Max.
T � � DiM. M7MPIQM
c FIT D
5 r
C� 61 -7
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TABtJIA".'I4R GF OSSER'�A".'IDA P'i'"S
Ground SOU
Flt
Locstscst � L,-d� water At mottli_n..
A
8
c
D cv
...Wage Dispoaa�.Sysz
FOR 4 #2 SOUTH WINDS 0 R HEALTH •2• lavestio". ou,for
DEPARTMENT '
S?MIAL CO'[9'Dl=oxs
S,Istsmt design larger tbaa 2,000 g.p.d. Water supply watershed
Sigh ground vater (less than 4+ ft.) possible seasonal high
ground Boater
Watercourse, marsh or pond Possible seasonal flooding
Litited suitable area Slope over ISV
.Marginal soil (30 - 60 mins./iach) Sballov ledge (less than T ft.)
Underlying tight soil (less thaw * ft)� Other.
CONCLi15IdN
Suitable for sewage disposal �•
unsuitable for sewage disposal Y'9
/ J
dditional iIIYestigitioa required v
� Retest during wet season
e g1m*r'.s plan required
DESIGN RECOHMMATIOIQS .
�(glu 1&6/k6- wad
Investigated by Title
Conti=ed/Witnessed by Title
Coc=ents:
Bench.mark location Elevation
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date A.Z, 3 19 4��
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property Address of Owner 4
2. Location of Property Lot. No.
3. Type of Structure No. of Bedrooms
(Dw n mmercial Building,Store,etc.)
4. Number of Families or Pg„Lgonc to Occupy Premises_
5. Plumbing Fixtures: Water Closets f Urinals IT Lavatories f Bathtubs
Showers_ Kitchen Sinks t Laundry Tubs_t Garbage Grinder Oth' r
6. Liquid Capacity of Septic Tank O 6 O Material of Septic Tank t7�
7. Soil Conditions: Type of Soil Maximum ground water table f
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of tren_ch�esy' L gth `S Widt Total 1?0d-
`
Other
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By