HomeMy WebLinkAboutSeptic Repair 618 Main Street 00
cow.
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYERS PERMIT
Application for Permit to Install or ep ' individual Sewage Disposal System
FeePaid $ .............. By AV 4-W............. S I V./.'E .5. ................................................ Permit No. ............................... .
Date .........................
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein
for repair -Y... or construction of an individual sewage disposal system concerning which the following
information is submitted:
X Address of Owner ...........................
1. Owner of Property ..........F9AN . ............P
2. Location of Property ...........Cleo ............
- ........................................................... Lot No. ..............................
3. Type of Structure ............................. . ....n-g. .- .r-c-i--. .... - .--- .- --..............................................................................
(Dwelling, Commercial Building, Store etc.)
4. Number of Families or Persop S 0 Occupy Premises ................. ................FrAffl)�--V- ................................................I.............
5. Number of Bedrooms .........Jr. ......................
6. Average Daily Flow ................................................... Manufacturer and
7. Liquid Capacity of Septic Tank J.&C..'. Material of Septic Tank ................................................................................
'11
8. Soil Conditions: Type of Soil ............................................ ........................................I........................ ..............................................................
(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 l!' drop in soil test ..............................................................................................................................................................................
Classificationof soil ....................................................................................................................................................................................................
12. Minimum square feet of effective seepage area required .....................................................................................................................Y...........I..............
13. Leaching System: Number of trenches Length .........../ 4�-/...........I Width ............0...............................
. ........ ...... Other ........................................................................................................................I.............................I..............
Total 32'37-0 .. .
14. Plot Plan Attached. ...............................................................
15. Layout Approved. ....................................................................
16. This permit expires ...................................................................................................................
Signature ....... ........ ... .. .................... . . .............................. ..............
(Licensed Drain La
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
...............................................................I.......................................................... 19.................. By ...............................................................................................................................................
...... ... ........
Pollution Problem abated Date .............................................................................. .............I..................e ............00....................................................
Inspector
i
N
r
r n
J9,
i
3o C.S, izso��
SO, �• 8
N
\ � i
r
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION G ►
OWNER ?-ANIZ 'P GRCZ
TYPE OF WORK Ss-::rfT\C. 3Z.E,9,6�t
DATE G- 2- PERMIT PIPE
INSTALLER �s a
INSPECTOR DRAWN BY