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HomeMy WebLinkAboutSeptic Repair 1124 Sullivan Avenue (2) i �nnrn of �nn#.� in��•ax� Department of Pollution Control SOUTH WINDSOR, CONNECTICUT' DRAIN LAYER'S PERMIT Application for Permit to Install or epair Individual Sewage Disposal System FeePaid $ ................ By ... I ;...:I ::: '`.................................................................................. Permit No ' Date . ! ....... .. 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 . z, Y¢' Address of Owner .. I , .... �UY`� .: : 2. Location of Property ..:...:::.... ..:;;..:...s:r........, :x.:.,,.....:a::::?...........,..::::;...................................................................................................... Lot No. .............................. 3. Type of Structure ............... ................................................................................................................................................................................................................... (Dwelling, Commercial Building, Store, etc.) 4. Number of Families or Persons to Occupy Premises .. ' j lr....r.. .)....: ,; - -- .........................................................................................................�._ 5. Number of Bedrooms ...':'i::.:.::.:..:,..... I. ............ 6. Average Daily Flow ................................................... _ Manufacturer and 7. Liquid Capacity of Septic Tank 4` Material of Septic Tank,11,411t%s .................................................. 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 �rS;! ' 7 From adjacent wells .....................r*i. :.... ,::,:;r.. ............................................ 10. Distance to nearest water course, drainage ditch, s rm dram 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 ................................................... Total ............................................... Other '..:: ....... .......:. .....:..:::.............................................................. 14. Plot Plan Attached. ............................................................... 15. Layout Approved. .. CANNED 16. This permit expires I Signature . ...... ....:... ..: .: ..::. r ..:..................................................................... (Licensed Drain Layer) t ( 1 ) Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances .................................................................................................................................... 19.................. By ................................................................................................................................................ Pollution Problem abated Date ..... .Q... d ..../...`..7.1.......... J ,......................................................... • ✓ Inspector I Z7 v k - 5c�w z Q NOTES SOUTH WINDSOR POLLUTION CONTROL LOCATION Z 1.lor to S�AtE, OWNER C. Alo TYPE OF WORK 3 PaAa DATEog t4 -71 PERMIT 71-4S PIPE INSTALLER AbAm INSPECTOR MF DRAWN BY M� q ()-E -T 4 lZop 4 lk AT Ci5 IPOT AT TC)" AS- 3 WOO 'X I�j w 1. W 3 W'-V C,)i.0 W.AT F 5 tJ 3TD` a ! ,O TD": Ab 'D 1134 5t4Lt lvAAJ & p r,8A x k6va 0. YhVt( L �1 A HONEY WAGON SEPTIC TANK SERVICE JOB 5� 245 Adams Street SHEET NO. S 11;.,.N Q , OF MANCHESTER, CONNECTICUT 06040 Phone 649.2330 CALCULATED BY DATE CHECKED BY DATE k�Q� SCALE .......................................r.............r.............(..... .............;..._.._....a......_....d............d.. j .................... _..... i _....... i a... €. 1........,.............:.__.....,..._.__....:..............:..............:.............a.............a.............a................... ..............._.. 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