HomeMy WebLinkAboutSeptic New 191 Newberry Road '
Department of Pollution Control
SOUTH WINDS0R, CONNECTICUT
DRAINLAYER'S PERMIT
'
Application for Permit r
Repair Individual Sewage Disposal System
Fee Paid
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer namednamedherein
for repair or construction of an individual sewage disposal system concerning which the
information is submitted: ~
l. Owner ofProperty ----'-------- Addreoo of Owner -----------------------------
2^ Location of ��--'1* r ��- ;..a-^................................................................................................................ Lot No. ---6.............
3~ Type ofStructure ----------------_-.--................................................................................................................................................................................................
(Dwelling, Commercial Building, Store, etc.)
4` Number ufFamilies or Persons to Occupy Premises ...............................................................................................................................................................
5. Number of Bedrooms ................................................
6. Average Daily Flow -----------------
Munufaoturerand
7. Liquid Capacity of Septic Tank ------------------- Material mfGeo�c �uo� ------------------------------
0. Soil Conditions: 7�n�eufSoil ----------.------------------------- .�
(Sand, Gravel, Clay, etc.)
Maximum ground water table ------------------------------------------------------'-
9. If not served 6vpublic water supply:
Distance from Ovvoers well .......................................................................
adjacent wwDu -----------------------------'
11 Diuhzoco to nearest vvutmr course, drainage ditch ut»nn drain or embankment ..............................................................----.
ll. Percolation Tests: Time for l° drop tu , test ....................................
Classification ofsoil ---'------_---___---_--_'--_---_-_--'--�—'-----�--'
12. Minimum square feet of effective seepage area required ----------------------------------------'---''-
13. Leaching System: Number of trenches ................................................ Length ................................................... Width ...................................................
Total ................................................ Other 14. Plot Ilnt P}uu Attached. ...............................................................
15. Layout .................................................___
16. This permit expires
--g----- -------°-'----------- 0 ......................................................
(Licensed Drain�L�a
IomtuDudou Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
-------'----.------'-------__-_' 19.'_-- By ____-____________________.____________
Pollution Problem abated Date ................................ ------------------_--__-__-___-___-___-__-_
•
ROAD
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LEACHING
GALL Euy
01
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o" i TANK
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I �-- C, ,
GARAGE To BE
CON N EC"TtE D
CHIMNEY
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER <�
TYPE OF WORK S PTiC- S rrly\
DATE 1 I i i : PERMIT PIPE v
INSTALLER C ovF-nl ,4
INSPECTOR -L,B, DRAWN BY D,L
OOU 6At , TA