HomeMy WebLinkAboutSeptic Repair 20 Sharon Lane 01 otutt of OoW4 Vinbsor
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install o Re air Individual Sewage Disposal System
FeePaid $.. ......,:: ` ......... By .`: . . r. k„ r ....................................................................................... Permit No :.:...........
Date�........ ::....................................I...........................
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 .. '.:::..'r ..... Address of Owner .......::
2. Location of Property ....::''.'f1.:.:.......................................................................................................................................................................... Lot No. ..............................
3. Type of Structure .................................................................I.............................................................................................................................................................................................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises
5. Number of Bedrooms .....(..:'4.................
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 ..:.!'{ :._..'...........................
......................
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 ............................................ .....
TotalOth ................................................. ....
14. Plot Plan Attached. er
:.............................................. ...
15. Layout Approved. ...........Yes.............................................
16. This permit expires .......:..:...............:.......................................................................................
Signature; ,. ...... ......... ..................................................
(Licensed Drain Layer),'
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
.................................................................................................................................... 19.................. By ......................................................................................................,,........................................
Pollution Problem abated Date .........07...Marxch,.....1.973................. .....::..Helviit Edwarddis,....Jr................................................................
Inspector
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NOTES SOUTH WINDSOR POLLUTION CONTROL
Drawixg xot to scale LOCATION 20 Sharox Drive
D/W- OWNER Johx Hills
A 28 TYPE OF WORK Septic Field Re air
B 59 DATE 03-07-73 PERMIT 73-01 PIPE41' O.B.
INSTALLER Davix (W -2p
INSPECTOR ME DRAWN BY ME