HomeMy WebLinkAboutSeptic Repair 637 Main Street V�-
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYERS PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
FeePaid $ .......... By ........................................................................................ Permit No. ...................................
Date .....................................
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein
for repair t/.- or construction of an individual sewage disposal system concerning which the following
information is submitted:
1. Owner of Property ............................. Address of Owner ..A.O.Q.7 M.A I.A. r .......................
2. Location of Property -09 ........... Pz3.11;......................................... Lot No. ..............................3. Type of Structure ...................................................................................................................................................................................................................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ...........0.&C c.il .............................................................................................
5. Number of Bedrooms ................................................
6. Average Daily Flow ...........................................
Manufacturer and
7. Liquid Capacity of Septic Tank ......................................................... Material of Septic Tank 60..'.......................................................
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 I" drop in soil test .......... .............................................................................................................................................
Classificationof soil ....................................................................................................................................................................................................
12. Minimum square feet of effective seepage area required .........................................................................................................
13. Leaching System: Number of trenches 1141kE-C �31............ Length E'.7...................... Width ..........3 E"'-
Totalt.,Al ............. Other ........................................................................................................................................................................
14. Plot Plan Attached. .....t.io...................................................
15. Layout Approved. ........... ............................. ..................
16. This permit expires Y.A:................................................................................
.
Signaturej,..........;;i-- ....... ..........................................................
(Licensed Drain Layer)
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
........................................ . . .......... By ............................................................................................................ .............................
............................ . .... .....
PollutionProblem abated Date .............................................................................. ...........................................................................................................................................
Inspector
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