HomeMy WebLinkAboutSeptic Repair 66 Pierce Road UUTaturtt of #o* 19inbsor
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install on Repair dividual Sewage Disposal System
FeePaid $.10.00................. B Adam...Wesnieski ......................................................................................... Permit No. ..... ........
Date .....19/2273........................................
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein
for repair ...X.. or construction ......... of an individual sewage disposal system concerning which the following
information is submitted:
1. Owner of Property .Barry...L......Sengman Sengman....................................... Address of Owner .6.6...Pierne....Pd....................................................
2. Location of Property ...same............................................................................................................................................................................ Lot.No. ..............................
3. Type of Structure .....dwelling.............................................................................................................................................................................................................................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ............0.10...Family..................................................................................................................
5. Number of Bedrooms ....3........................................
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank ......140.0..................................... 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 ....7 ...F'.t..................................................
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 ...:..3.75 r'q......1t........................................................................................................
13. Leaching System: Number of trenches ................................................ Length ................................................... Width ...................................................
Total ................................................ Other .........................................................................................................................................................................
14. Plot Plan Attached. ...............................................................
15. Layout Approved. ....................................................................
16. This permit expires ............1.2f2-2/7..3..........................................................................
Signature .... ......... ........ ...Q'1^'L.......... ......... �'" C(Y<,�r... ....Y.............................................
Adam Wesniewski (Licensed Drain Layer) W9_2o6559
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
............... .. .............. ...c ........................................................ 19..7 .. By .................................................................................................................................. ..........
Pollution Problem abated Date ................................:....................
......................... . ..................... . ............................................. ................
Inspector
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION ��
OWNER �Vy L
TYPE OF WORK T/e s
DATEz PERMIT
INSTALLER 101
INSPECTOR f r DRAWN BY f'