HomeMy WebLinkAboutSeptic Repair 1015 Pleasant Valley Road (2) TOWN OF SOUTH WINDSOR
ALTH DEPARTMENT
Application for permit to install a new subsurface ewage disposal system. To the Health Department,
Town of South Winds9r. �l
Fee Paid -V ,�y Date ` 7 Permit Number g6—�
As a s bsurfre �ewage disposal syste inst ller Ii/ensed in a State of Connecticut, I
f7,_, n/ mot`
Name, AclUreSS, Telephone Number, License Number
hereb apply for a1 perf it to cc structlrepair a subsurface sewage disposal sy tem located at
f®f &L-FA SAS I l 72 LEy a and owned by �9d1,D T u Try
Street, Address Lo Number Name
Ad-dress
Information to be suppliq by Ap lica t:
Type of dwelling trS IMA"r)� If non-residential, estimated daily flow
Residential,Commercial,Etc.
Number of bedrooms 13 Size of lot !• 2-
Number of fixtures above basement
Tubs,Sinks,Toilets,Etc.
Number of fixtures in basement, if any
Pumped or gravity flow,
Type of water supply . If private,type of well �—
Public-Private/
Information to be supplied by Health Department: /�
Soil type at various levels J�d V laa"- L W4a e
Percolation rate 2-01wo //At Square feet of effective leaching rea required-
Size of septic tank ld av Type of system
Trenches,Drywelis,Etc.
Number of dry wells, trenches, etc. 3 Distance between individual leaching
units. Distance from well on same propertyf'` on adjoining property
Curtain drain required -/0
Yes,No
Height of system above ground water maximum ground water 6 ,
ledge ' impervious soil layer .a Ll
If automatic closing is required,description
I
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.
Z Z
Permit Received by Date
Signature o Ap 'Gant&Lice se Number
For Office Use Only
Permit issued by Date
System installed by
Final Inspection Approval Date l— ff6
STATE OF CONNECTICUT
9 DEPARTMENT OF HEALTH SERVICES
q
DATE :
SaT: "Sau`�}� J P`l'1�.5 , CONN., REVIEW OF ENGINEERING PLAN FOR A HOUSE)iOLD
SUBSURFACE SEWAGE DISPOSAL SYSTEM ON ��-o� c�'J V1y 'Of�V 1 TC�k � �)l�L V�—o►�
TO:
FROM: Theodore C. Willerford, Principal Sanitary Engineer
ENGINEER: DATE RECEIVED
REASON FOR SUBMISSION:
MDrIMUM PERCOLATION RATE POORER �NEW CONSTRUCTION
(—J THAN 30 Mn=ES/INCH
❑ REPAIR
�HIaH MAXIML�{ GROUND WATER LEVEL PGaSS r D SHALLOW LEDGE ROCK
OTHER
DESIGN SPECIFICATIONS:
NO. OF BEDROOMS DESIGN PERC. RATE 2-� MIN.IIN.
SEPTIC TANK GALS. LEACHIRG srgrEM"�r'RrcNGl-1�a— 75 x3'= 6-7'S7 '
77U SYSTEM FEET CURTAIL( DRAM 1Vo r3�,
RECOMMENDED ACTION:
❑APPROVAL,
❑APPROVAL WITH MODIFICATIONS OR PROVISIONS NOTED ON ENCLOSED PLAN.
CONDITIONAL APPROVAL SUBJECT TO FURTHER TESTING PRIOR TO INSTALLATION AS NOTED ON
ENCLOSED PLAN.
❑APPROVAL DENIED. SITE UNSUITABLE FOR SEWAGE DISPOSAL.
❑APPROVAL.DENIED. INSUFFICIENT INFORMATION ON PLAN.
®APPROVAL DENIED. REVISE AS NOTED ON ENCLOSED FLAN AND RESUBMIT.
(�APPROVAL DENIED. FUNS SITE INVESTIGATION REQUIRED.
COMMENTS—J �� � »ra w �2, off,\lPt�lc►�1 p i'1f
P�1� o'F �-6''Gl�l ti1Cr 5y 5 C'�"� �t t.�Ca✓'R tf�C-�. M m►� t'�'GtLc-� 'Dv2,r r.�0,.• �.t f�t-
�,43 , �yEl.- }'Q?a�S `B�iJ ���'�J•'t /B•lEtj o �JM'P 17JCr M.A"1 $fc. '(�t?y t(LE�.
COPIES T0: (g�-}
t ►u�-� S3G— �GI�� Sincerely
❑DIRECTOR OF REAM w`Tt-1 Srr�va osz CrfLAu� P-$422-- C�cr�ve&'tte%j /0csT
❑SANlTARIALI C. S`
�Et�IN> Phone: 566-1251 On-site Sewage Disposal Section
❑ CFTM 150 W4zd;A,,,4,,H_``feet — Hartford, Connecticut 06106
An Equal Opportunity Employer
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NOTES { a . SOUTH WINDSOR
LOCATION c 15-
-&5— OWNERAuy !loln
TYPE OF WORK P
Dh !`t"li%J1O19 t-Ln _8J- DATE -r- ';L-86, PERMIT PIPE-
INSTALLER Covej3
INSPECTOR J99 DRAWN BY TD
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NOTES
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LOCATION v e
instal, �r� rev/sigh 9-3 -SS- OWNER o
TYPE OF WORK &
Dh rr�jJleti 8_Lv _8 f- DATE -?--S PERMIT PIPE----
INSTALLER Clove
INSPECTOR J99 DRAWN BY
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BE SET
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6 Test ''it B C
Test Pit A
0 "-6 "a.ndy Loam
I.,��?'
6 "-54" ' Lay „7 �I ,-l a"
54"-8 . 5 ' - silty sand 52"���„ Sand-
-
lavers , clay A I -9
s om.e
layers a !; Clay
Ground date ��@ � / / 90"-fl . �• ' - Sand
(a Mottle 60 65 Clay
mixture
DD ��� � lavers
SEPTIC SYSTEM CONST-
RUCTION ti -
/Q N ®II Q rq I Cti.4PMi9N
Total area within and �I�z 'W W
between leaching: tre- � ° � / / u, � ry I mottle � 6�"
aches to be stripped Sent�
�c Svc terl
I �' °I�• �1
of topsoil and filled n► r-
n► rest
with pervious soil to� " ae "
elevation 101 . 0 and "i X / `�° 3 Be rooT^ Res .
compacted. Leaching o ? Uerc-use 20 T-~ .r.
trenches shall be du U) f0r fill soil - I
down. below clay laye �� g , Re uirec� 67S
and ba.ckf i.11ed to SF
Leach in,' Are
9B .` h /
clean sand. Excava- 97-5' h Use - 3 Leaching
tion and backfill to aas SS' + Trenches - 75 '
be approved by the / T i Long - 3 ' Wide
Sanitarian prier to i 775T PYF S Use 1000 Gallon
T�lacing stone or
�•� /VD ��"'IO- �f�.2 qb � ; Septic Tank
1.-)ine for leaching �
9-3
trenches .
50,148.L9� 0 0
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-TOP 6/P0VA140 96.9 ?
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f'ROf'ERT y OF OA VZO w. T/LL M. OUTT1 N
9 93 PUS.-g5AN T' V,nLLEY ,c?,0A ., S11UTy W,1AA ,0,e
LUCEK ENGINEERING ASSOC. INC.
NO. REVISIONS DATE SCALE, S/O DATE�j/s/�S
CONSULTING ENGINEERS I USE LSAC-Htu& TQ'C�►GN S`( 'TF*1 B-14-815
490 BUCKLAND ROAD 2 T S S I To AZFA 2 SON .g DRAWN MLC/ j CHECKED I WL
ST
SOUTH WINDSOR. CONN.
203-644-0550 - - PROJECTB5'>T7 SHEET I of
I HEREBY CERTIFY THAT THIS MAP AND SURVEY WERE PREPARED IN ACCORDANCE WITH THE
STANDARDS OF A CLASS SURVEY AS DE'fM D IN TH XISTING "C OF PRACTICE
FOR STANDARDS OF ACCURACY OF SURVEYS AP ", PTED B E CONNECTICUT
ASSOCIATION OF LAND SURVEYORS INC.
8,4RRINGTI>N L'DiVl�O�$/�1//U/''� ASSOC
zip 7-D 96 ge SEr
8.E SET
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- - --- I I Test Pit B
Test Pit A
D "-6 - Sand,
0 andy Loam
�FJ^�hfC�C�'" Lo a:�
6 -54 ' ` -ay i� i qg b� s o 6 "-52" - Clay,
i 5'�"-3 . 5 - silty sand 52"-90" - Sand-
layers , clay 1 some
layers , Clay
Ground G"ater @ 7 �``' „maw / / S . 5, ' -- Sand
I Mottle 60"-65" 90 Clay
�i4 L
I ► mixture
Special Note : a �,,, �h � �t q� I� layers
- L e a c b i n g: e� /N 4C'
Trenches to be exca- W W
-.-ated �0 �� "' I Mottle @ 6n"
tr below Clay �` 4ga �� Uj Q-
gn
ana A ��q�'l Septic System
ra wit I
pervious sand or � ' Udroor
rrave.l . Excava- 0� a, x 3 Be room Res .
' tion shall be anpro- o 2 1 qb �'erc-use 20 rrin
ved by sanitarian u for fill soil -
Prior to backfill . 0 Reouired 675
cF 7..Aarhi.n Are
0 M yB"
h
a6�O h / Use - 3 Leacbinp
T-renches
i . Lonp - 3 ' 1-Tide
-nrsr P/r 8 Use 1000 Gallon
s-tiN� rry Geo�.vo- 9 . !L J Septic Tank
eon .' .ya rr/E93/t qb
Heat e;-w LIL
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993 PL�'�lS�1N7' VALLEY loco -1 , SdUT.S� yvic�I.sO.�.
LUCEK ENGINEERING ASSOC. INC.
NO. REVISIONS DATE SCALE/ S/O DATE V_f/lps
CONSULTING ENGINEERS I Ugr< LEACIAl u6 T2V�►C0 SY _TE- 4-8 1-
2fytAtjp sy5—i DRAWN MLD CHECKED -"WZ
490 BUCKLAND ROAD
SOUTH WINDSOR. CONN.
203-644-0550 PROJECT*$37 I SHEET I of
I HEREBY CERTIFY THAT THIS MAP AND SURVEY WERE PREPARED IN ACCORDANCE WITH THE
STANDARDS OF A CLASS p"2 SURVEY AS DE D IN TH XISTING E OF PRACTICE
FOR STANDARDS OF ACCURACY OF SURVEYS AP ", nPTED B E CONNECTICUT
` ASSOCIATION OF LAND SURVEYORS INC.