HomeMy WebLinkAboutSeptic Repair 1031 Main Street - �� �F:•x �:'^,s- ,�. �=.ram 2„�$ �3.'-:„�.f `�°.,�.�,� E �"
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C, ount of OvW4 Mitboor
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAT§ LAYER'S PERMIT
Application for Permit to Install o epair Individual Sewage Disposal System
Fee Paid $...............::....::!: B ...... Permit No. .........................
y ........................................:.............:.........:.......:..:..............................................................
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 ..........:.:...:::.....�.::'.. ..........: i.',::..........................................................................I..........................
5. Number of Bedrooms ................................................
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank ....................:...........:.....:.....:........... 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 ..........::.............:...........................:.............................................................................................
13. Leaching System: Number of trenches ..................:.............G............. Length ..............:..:................................ Width ................:..................................
Total .:...............I.............................. Other .........................................................................................................................................................................
14. Plot Plan Attached. ...............................................................
15. Layout Approved. ....................................................................
16. This permit expires ......... ...........:.......:..................:...::..........................................................
Signature ..........................................
...............:.:...........................:...............:::.::..:....................................
.............................
(Licensed Drain Layer)
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
....::......:::..........................::..................:...................................................................... 19.................. B
PollutionProblem abated Date .............................................................................. ..................::.....::............................................:...:...........................__..........................,......
Inspector
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NOTES: Scale = 40, in 1" approx. SOUTH WINDSOR POLLUTION CONTROL
S T D/B LOCATION 1031 Main Street
.2 73.1 OWNER K
B 66.4 72.2 TYPE OF WORK Septic Repair
Point "A" is the north side of the DATE 0 -2 -72 PERMIT 2- PIPE4" O.B.
garage door INSTALLER Adam (W9-2065595
INSPECTOR ME DRAWN BY ME