HomeMy WebLinkAboutSeptic Repair 11 Marilyn Road down of #o* Wittboor
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install o Repair Individual Sewage Disposal System
FeePaid $....r .......... B ........................................................................................ Permit No. .... ... .. ��. ...........................
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 ..........A.�.�f}, ....1........... ..,.lkW# VAdress of Oner ....�1.....1vr/. ..............2. Location of Property .. .........l.l......o*...t.'ff:�. .�f./��...... ..O ....................................................................................................... LoE No. ..............................
3. Type of Structure .......... .. .. .`.f..1.I.............................................................................................g'.....t-o- ...'......................................................................................
(Dwelling, Commercial Buildin Store etc.)
4. Number of Families or Persons to Occupy Premises ...............&..t�K.............................................................................................................................
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 .....C:.../.Y.Y. ....1� ....................
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 .................:.............................. Length ................................................... width .......................I...........................
Total ................................................ Other .........................................................................................................................................................................
14. Plot Plan Attached. ...............................................................
15. Layout Approved. ....................................................................
16. This permit expires .........................................................:.........................................................
Signature .. ... C3: : .u: ...-.... ... ..'...... .l..��.V!c!..V :��/.. ...
(Licensed Drain Layer)
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Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
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:........ ............... .................. ............................................................... 19...7.. .. By . , ...................................
Pollution Problem abated Date ................................:..........................................
...
Inspector
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NOTES SOUTH WINDSOR POLLUTION CONTROL
s► LOCATION 11 M xi-i I q ol Rd
OWNER ar I ai rwc�v,
TYPE OF WORK si:- i c- Rv a.j r
DATE /S PERMIT 7 -39 PIPE
INSTALLER
INSPECTOR DRAWN BY
/,-TG/) 7-1 a
TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut ' -
Application for Permit to Install or Repair Individual Sewage. Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date. t9.2 41012,1 19 '7/
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property
EAAti (At2MA4 Address of Owner 9Aa44r
2. Location of Property /1 MA"/-!J i �-"Ao Lot. No.
3. Type of Structure 'b W€LJ- wt No. of Bedrooms
[(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises O N C C-0 r-AA-t 1 L.Y
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well PO&LLG- from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Widths, --• Total
Other W494UL Fat &ACUIAs
Signature
(Igf—en/4d In
(Sketch showing all minimum distances and gtk*f QQQQQQetai s r6quired below)
Permit Issued a a Ao zn- 19--7/- By
Installation Completed, Inspected and Approved 19 By