HomeMy WebLinkAboutSeptic Repair 374 Strong Road omit of On* 10inboar
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
FeePaid $........... By ................................................................................................................................................. Permit No. .7 '. ..................................
Date ................1.Q...,-.1 �I Y
... ...... ...
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein
for repair or construction X.... of an individual sewage disposal system concerning which the following
information is submitted:
1. Owner of Property ..........q!47 ...................................... Address of Owner -3.24_ t X:P
2. Location of Property klo '1 ..............I....................................
K�T-
-............. j!!!�q W'e*8'*t'*"*R0'ad'* Lot No. ..............................
3. Type of Structure ............. ...........................................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ................................................................................................
5. Number of Bedrooms VYA.......................................
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank 1600.0 QA110mir.......... Material of Septic Tank ..........................................................................................
8. Soil Conditions: Type of Soil .................�$�a A C1
(Sand, Gravel, Clay, etc.)
Maximum ground water tableN.0 gr mA4
9. If not served by public water supply:
Distance from Owner's well kAblIA
Fromadjacent wells .............................................................................................
10. Distance to nearest water course, drainage ditch, storm drain or embankment et
11. Percolation Tests: Time for I" drop in soil test ....... ....:(2).. .. ..... ..... .......
Classification of soil ......................
12. Minimum square feet of effective seepage area required ...... cl '..,l.................................................
13. Leaching System: Number of trenches ................................................ Length ................................................... Width ...................................................
Total ................................................ Other ................................................
14. Plot Plan Attached. .....Xi.M
15. Layout Approved. ....................................................................
16. This permit expires .........................................
Signature
..........................................
."Ur"T1 Wi.rtlue &rt(Licensed Drain Layer)
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
.................... .. . ........... /......................... 19.Z.- By ..................................................................................................................
/�7
Pollution Problem abated Date ................................ 114'
... ......... .......... .............. ..........
Inspector I