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HomeMy WebLinkAboutPermit to Discharge Repair 653 Main Stre SOUTH WINDSOR HEALTH DEPARTMENT (Household System) PERMIT TO DISCHARGE Approval is hereby given to TerrX & Judy Stoddard - to discharge to a Owner subsurface sewage disposal system located at 653 Main Street in the town of South Windsor which will receive treated -domestic sewage from a dwelling containing two bedrooms. PROVIDED: 1. Liquid discharge volume shall not exceed 125 gallons per bedroom per day. 2. The septic tank shall be inspected regularly and cleaned not less frequently than every five years. Construction Permit No. — ------ Installation inspected by Robert Deptula Title Env. Health Officer Date of final inspection 4/27/93 Issued by: Robert De tula R.S . Director of Health or Registered'-Sanitarian) Title Environmental Health Officer Issuance date 5/27/93 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - SPECIAL REQUIREMENTS OR RESTRICTIONS: EXCEPTIONS: 5/93jh r 1 � T � aw / s v J to / YK YV 1� i Ib t rn c�.i� ;�� • NOTES SOUTH WINDSOR HEALTH DEPARTMENT LOCATION 65-3 Mai" Sy` OWNER S'-/o al d a TYPE OF WORK a it DATE Y-21 PERMIT PIPE INSTALLER v o we INSPECTOR RO DRAWN BY RD ;,Ao Q d TTOS P==D S:Lld SOLI` A'asao ao SOI.i,7IIlM al ouj o I/ 1:,5r1P�-Ae c� e au I 0 SId H ;Sa b =a • ladlLosa-C uo ]t •7Cej+i tLOTag �•Xeri S88h n'c Z _ S T sm *Tog all Ai II©Tt:�TitTOaXad- wroTmm iS�sd daQ sS'lills2i Z ss td0 KOLLVItlDZ 1i rrtTp'ea� amp;, ( BQLpsad ftnmu emu ag WTZ Sam 3#1 Z= lc# ma s-trait :ZuzszoW uos go mmz uouYloma 4.S 9 )tor ooz -� � P Q s o xs aSiC 3J�s3S �a �zzvOLl�abu . . . . n.,.. �,. . LHRWINYd34 HIIYRH NOSQHIM HIfIOS �A ,G,,',!;F .L'.=4 # SOUTH WINDSOR HEALTH •2• Investization.for Svwage, Dispos&L.Sys-�- DEPARTMENT SPDCIAL CONDITIONS System design larger than 2,000 g.p.d. Water supply .mtershed Aigh ground water (less than 4+ ft. ) Possible seasonal high ground water Watercourse, marsh or pond Possible seasonal flooding limited suitable area Slope over 15%•. Marginal, soil (30 - 60 mins./inch) c�,r.sJL ov ledge (less than 7 :rt.) Underlying tight soil (less thaw 4 ft) Other CONCLUSION 2—d Suitable for sewage disposal Unsuitable for sewage disposal • Additional investigation required Retest during wet season Engineer's plan required DESIGN RWOP24MM►TIONS a G�Q/r h 30 0 Investigated by � o Title Confirmed/Witnessed by Title Comments: Benchmark location Elevation rVtSP'1 )Tl uvu11! 11a41V0VK% 14A:na,an uDrt11%1P1r,1V1 APPLICATION FOR PENT TO CONSTRUCT OR REPAIR A SEWAGE DISPOSAL SYSTEM (Office -use owy) APPLICATION 90. TO THE DIRECTOR OF HEALTH TOWN OF DATE_ Application is hereby made. for permit to construct a sewage disposal system for a (Regiden a Store, Reit==tp $ta. Located at (Street Address, Lot Number, Subdivision Name; Map, Block, Lot, Etc* New System Additioa_ Repair L�-' other owner W6 clala✓,d Address Ajoa r.� Tel-No. Installer Address 97 d r Ilern a in Tel.No. S*7/-?96S- Installer License No. 3 Y5�6 In accordance with detailed information stated below Signed l (Owner or.dv4y authorized repres tative) Application Pee paid GENERAL I14FORMATION Siubdivision Approved Date Lot size �1 p k5 0 Sq. ,.t. On Public Water Supply Watershed On Designated Wetland �- SCS Soil Classification public Sever Scheduled Date If residential, number of bedrooms Flood zone _f non-residential, design criteria; (Sanitary Facilities, No. of Employees, Meals Served, Etc.) Basement Fixtures Foundation Drains Special Equipment ET NGINEER'S PLAN REQUIRED EST DURING WET SEASON Water Supply- Vvtb`;C Type Well -T well Location Approved Yield Satisfactory Sample (Date) Well Driller's Name Address rWATER SUPPLY APPROVED s FORT. SOUTH WINDSOR HEALTH DEPARTMENT APPLICATION N0. CHECK LIST REVIEW OF P'IAN/INSPfETION OF SEWAGE DISPOSAL SYSTEM Date Owner $ J 01J Location 65-3 Mae,,- Plan prepared by Title Address Site Investigation y/5 --9 3, Investigated by (Date) Bench mark location Elevation Design Percolation Rate Mins./inch at hole(s) If residential, number of bedrooms__ If non-resideatial, estimated daily flow . HOUSE SEWER (INVERT LEVELS) Depth at foundation wall o?� rr Depth at septic tank 3O ST-1MC TANK cleanout located ft. from and ft. from ?•lanufacturer ✓ IL_40.ds Size / v_�/a gals. Depth to eleanout /�_ LEACHING SYSTEM Description Effective area 36 p sq. ft. Required effective area 3 O U sq. ft, ,pacing between units ft. 1001 reserve area provided — Bottom of leaching system 18 inches above maximum water table Rottiom of leaching system 4 feet above ledge rock acztom of leaching system �{-d 7` inches below final grade. ?umping required Curtain drain required serial distribution Level system Lf SEPARATING DISTANCES Nell located N6 ft. from aad ft. from Distance sewage system to well on property 4,,4 ft. To water service ft. Tc w4=11 on adjacent property y O- ft. To property line ft. To house served S ft. To dwelling adjacent property /licA ft. To nearest watercourse_ f: To nearest ground or surface water drain 1�p` ft. ",eviewcd/Inspected by p C) Title PIAN/INSTALLATION APPROVED t/' DATE y a 7-0 INSPECTION FEE PAID �/ TOWN OF SOUTH WINDSOR HEALTH DEPARTMENT Application for permit to install a new epai subsurface sewage disposal system. To the Health Department, Town of Sou 24nsor. _ Fee Paid f��S Date �'a7' ' Permit Number As a subsurface sewage disposal system installer licensed in the State of Connecticut,, I n Name, Address, Tele hone Number, License Number hereby apply f r a permit to construct/repair a subsurface sewage disposal s� s em ocat�d at �111 w�n S and owned by �,_o �l � (� Street, Address, Lot Number Name a—— Address Information to be supplied 4 Ap lic t: Type of dwelling �q�l 04 If non-residential, estimated daily flow Residential,Commercial,Etc. Numberof bedrooms a Size of lot Number of fixtures above basement Tubs,Sinks,Toilets,Etc. Number of fixtures in basement, if any , Pumped or gravity flow, Type of water supply Mn C If private,type of well Public-Private Information to be supplied by Health Department: Soil type at various levels Percolation rate! Square feet of effective leaching area required 3 Size of septic tank /t oo Type of system firr­,44e.s Trenches,Drywells,Etc. Number of dry wells, trenches, etc. Distance between individual leaching units. Distance from well on same property on adjoining property Curtain drain required Yes,No Height of system above ground water maximum groundwater > ledge impervious soil layer If automatic closing is required,description A PLOT PLAN INDICATING LOCATION OF PROPOSED STRUCTURE, WATER SUPPLY, SEPTIC SYSTEM, EM- BANKMENTS, WATERCOURSES, PROPERTY LINES AND ALSO INDICATING EXISTING AND PROPOSED FINISHED GRADES MUST BE SUBMITTED BEFORE THIS PERMIT CAN BE ISSUED. THIS PERMIT IS NOT TRANSFERRABLE FROM PERSON TO PERSON OR FROM PLACE TO PLACE. NO PART OF THE SYSTEM SHALL BE BACKFILLED UNTIL IT HAS BEEN INSPECTED AND APPROVED BY THE SANITARIAN. SPECIFICATION AND REQUIREMENTS AS STATED IN THIS PERMIT MUST BE MET AND ANY CHANGES MUST BE APPROVED BY THE TOWN SANITARIAN BEFORE FINAL APPROVAL WILL BE GIVEN. THIS PERMIT SHALL NOT BE CONSTRUED AS PERMISSION TO CREATE A NUISANCE CONDITION NOR IS THIS SYSTEM GUARANTEED BY THE HEALTH DEPARTMENT. Permit Received byY--- 4 Date o2 714)r- �_1 Si nature of Applicant&License Number For Office Use Only Permit issued by Date System installed by Final Inspection Approval Date 'aw 1/G� Gu ' ��f > �rr TERRY L � OUD,Y�STODDARD _-�- �r ; /oar , - sr � MAiN STREET - 1wM z; ,- E •�3J, ` ` SOUTH WINDSOR CONNECTICUT' ` n 20 .00T 1986 iaALE 1 " 30� R Y 42.9•' L_J V -, --------------- 1 W1 o b •Q b ,�o 7- ZONE /9-4 O tit o U 2 Aericn/ of r.�k� �rswt U�t(1 � .aisi�..��r�s .veers .8��•�.� V So o ye ./'�icisl7M� :cc,--v*G 50 YKWD '`•-ne -v-cows sce y 00 Ta mw~7',.Z aNi.v c Z \ .��6�,eT S• STicJ.FP �t . .ea�si ?.✓. v scPr G 4. df �/�/IN �TIC-��F I GNCy/. NoT7n6� C�DNST.CIJ.�/� s vevEy Thee y ,C. �Sao srb lea Aev: . FREOY DECLARE T0! ~NIGriGGT Af7�P-N�`XS rrc� �.r<cs�..��+.r..F �o..r,4ntiy %T THIS MAP IS SUBSTANTIALLY CORRECT, 1T •UILDINGS ARE LOCATED AS SHOWN ) THAT ZONINS REOULATIONS,AS THE? DECLARATION VALID ONLY ON MAPS ITAIN TO SUILOINS LOCATION AND LOT SEARINo EMSOssEO SURVEYOR'S SEAL ENSIONS ARE NOT VIOLATED UNLESS '4ERwI:E SHOWN - HALLISEY S HERBERT tiINEE a "LAND SURVEYOR$ S .. s -OEAN HIGHWAY;ROAI CONNECTICUT50 SILAS: . ' 8 ENo 3 i ` '-S.FY=�'"£e.r.'"�7 v,:_t" 7 's +k i 33=,,, '•'M ,�i � sil:+` M O