HomeMy WebLinkAboutSeptic Repair 30 Scantic Meadow Road '
Department of Pollution Control
' SOU]IDWOND8OR, CONNECTICUT �-.
DRAIN LAYERS PERMIT � ^'
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Application
for Permit to Dnwtall4 Individual Sewage Disposal System
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Fee Paid .............. By
Pursuant towritten application, permission is hereby granted to the Licensed Drain Laver named herein
for repair --- or construction --- of an individual omvvuge disposal oyohau concerning which the following
information is submitted:
1. Ovvoor of Property .............. ............. Address of Owner —__-----....'-----'--.--------
2i Location of Property ............u--__--'---'--'_---_'_-_'_-----'_------___----..Lot No —'------'
3` Type nfStructure ..................:...............
...........................................................................................................................................................................................................................
(Dwelling, Commercial. Building, Store, etc.)
4. Number wfFamilies or Persons to Occupy Prezuisem ----+--.... ................................................................................................................................
5. Number of Bodznoom '...^.----'3--.--�
6. Average Daily Flow ...........................................
Manufacturer and
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?. Liquid Capacity of Septic Tank ......................................................... Material nf Septic Tank —'......'-----__—_'- ............................... '
0` Soil Conditions: 7�n�a of Soil _'-___---_--'__-_---_--_�_-'----'------'-------------_----�
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(Sand, Gravel, Clay, etc.)
Muxbmozu ground mmtortuble --------------------------------------------------------'
9. �If not served by public water xnoolv '
Distance from Owner's well ------------------------ '
From adjacent vvwQo --'_---'_'_--'_--_-_----
D% Distance to nearest water course, drainage ditch storm drain or eoubuokzueot --_---_--'_--._-------- �
lL Percolation Tests: Time for l° drop tu soil test .......................
Classification mfsoil —_
�� Minimum og�uro foot of effective omm�ugm uzmu ' �.
13. Number of trenches Width ..................................................
Total 3.9.0 Aq ftt. other --_---- �
14. Plot Plan Athuubed. ........
15. Layout _____
16. This permit expires ..........................................................
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(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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Pollution Problem abated Date —
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Inspector
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NOTES SOUTH WINDSOR POLLUTION CONTROL
Scale = 40' in 11' approx. LOCATION 30 Scantic Meadow Road
S T #1 #2 OWNER
A 24 27 31 TYPE OF WORK Septic Repair
B 10 32 46 DATE 01-08-73 PERMIT 72-105 PIPE4" O.B.
INSTALLER Silvester (W -206440)
INSPECTOR ME DRAWN BY ME