HomeMy WebLinkAboutSeptic Repair 560 Miller Road TOWN OF SOUTH WINDSOR
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- ALTH DEPARTMENT
Application for permit to install a new epai subsurface sewage disposal system. To the Health Department,
Town of South Windsor. �— e0_ 8—!06_ Permlt
Fee Paidr f`i Date Number
As a su surface sewage 1 o al system inst ler I' erased in the State of Connecticut, 1
Name, Address, Telephone Number, License Number
hereby pply for a i to onstruc /ulbair ar su surface sewage disp sal syste ocated at
d?and owned by * r
Street, lr& Lot Number Name
c
Address
Information to be s pp dky Ap ant:
Type of dwelling . If non-residential, estimated daily flow
ntial,Comm r ial,Etc.
Number of bedrooms Size of lot
Number of fixtures above basement 40&1 'r; '
Tubs,Sinks,Toilets,Etc.
Number of fixtures in basement, if any ,
TD/ Pumped or gravity flow,
Type of water supply 474V&2 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
Size of septic tank A-2 Type of system
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 ground water ,
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.
! /JJ 4ff
Permit Received b ate
Sign of Applicant 8 Lice Number
For Office Use Only
Permit issued by Date '
System installed by
Final Inspection Approval Date ��ti0
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SOUTH WINDSOR HEALTH DEPARTMENT
NOTES � � ,��� . LOCATION S6v 1 ill e rid
OWNER C- E
TYPE OF WORK
DATE ib— d'—f r PERMIT PIPE
INSTALLER c-41-
INSPECTOR DRAWN BY
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FLIN fe SOUTH WINDSOR HEALTH DEPARTMENT APPLICATION NO,
D
INVESTIGATION FOR SEWAGE DI.SDCSAL SYSTEM
Owner LOCATION
FEACOr.ATION TEST^: (Record all. tests) SOIL, MOISTURE:
Date , med., low, etc.
TAT READINGS
HOLE #1 ncLE #3 EOLE '
Time Reading Time Reeding Time Reading Time Reading
TABULATION OF TEST RMLYL TS
Depth PresoakMinimum .Percolation Rate
Role Location (Ers. ) (Mins./Inch)
1
2
3
CBSERVATION FITS: (Record all pits) Grcund Water Table-.
ram, Near Max-, Below Max., c
02L DE'CR1?mTO`,;�
PIT A FIT B PIT C I PIT D
O a d y/t"T o-12.
� t o�pu� s)`/1/ l t.4y- r�l s�,,
e fa apt �i ley Sam,d
s0,Lt p��) V-
y�-
�.VV Lys 6'k/ $10 WL;'f 4. to
v,4o+4(C
l' TABULATI ON OF OBSERVATION FITS
Ground Soil
Pit Locaticu Depth Ledge At Water At Mcte9Ing a
A
B
C
D
Over)
C , 7-0�� 074e So
G U
o wG 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CONN. 06074
soe•co AREA CODE 203/644-2511
May 15, 1987
Mr. Leonard J. Norton
Land Tech Associates
13 Middle Turnpike,East
Manchester, Connecticut 06040
Dear Mr. Norton:
The sepitc system design prepared by Land Tech Associates
for Lawrence A. Fiano, Miller Road, and dated 12-27-87,will be
approved with the following modifications:
1. A bench mark to be set
2. The water line must be shown
3 . General note number 2. should read " . . . . . . .as directed
by the local Health Department. . . . . . . . "
4. General note number 6. should read " . . . . . . .of the in-
staller (license septic system installer) . . . . . . "
The design will be approved pending these additions and
corrections.
Very truly yours,
Robert De tula, R, S.
Environmental Health Officer
RD/chm
y
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