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Home My WebLink AboutSeptic Repair 1504 Sullivan Avenue SOUTH WiNDSOR HEAL H DEPARTMENT APPUCATICY N0. 1 ` INVESTIGATION FOR SEWAGE DISP@3AL SY ,.� owner LOCATION ?=OLATION ":EM: (Record all. teats),C;3-r.*- Date SOIL MOISTUIR,E: •" , med., etc TEST READINGS HOLE #1 =3 #2 HOL^c �3 EOLE , Time Reading Time Reading Time Readng i Time Reading �0 6 io er /a i7 LULIE !re z 3� Ls' U TABULATION OF TEST RMULTS Bole Location Depth Presoak Minimum .Percolation Rate Ers• ) (MIns./Inch) .2 3 CaSERVA'ITION PITS: (Record ell pits) 6-3 Ground Water Table- ;dear ;r;ax. Be oxiex. etc 02L PESCRIP?'IC�,� PIT A PIT B C I - �' PIT P 57Ai Goy AOd s04-d- ,rvu+•E- rf if YP-,:f-Y _-wYV-/e TABULA^'tON OF OBSERVA'PIOR Pit Locaticu Ground Soil Depth Ledge At dater At McttZ_4n; A B C D ov,!r W w..A D V U 1!Z f9 1 lY uJ"J" 11 Lt%L 111 yii�.cS 1r1},GviL.:y 1 VT J :ILM - - . DEPARTMENT SPECIAL CONDITIONS System design larger than 21000 g.p.d. Water sup p]y watershed ffi.gh ground water (less than 4 ft.) possible seasonal highs ground water at Watercourse, marsh or pond Possible seasonal flooding Limited suitable are& Slope over I5%•- Marginal soil (30 - 60 wins./inch) Shallon ledge (less than 7 ft.) Underlying tight soil (less than 4 ft) other CONCLUSION Suitable for sewage disposal Unsuitable for sewage disposal Additional investigation required Retest during Wet season Engineer's plan required DESIGN RECOK�MMATIONS investigated by Title Coafi=ed/Witnessed by Title Comments: Benchmark location Elevation B. & G. PLUMBING ; i"; D' i1 P. O. Box 338 -% i L L ii l GLASTONBURY, CONNECTICUT 06033 Phone 569-4159 DATE .................................. ._t�v .........................................d/C.....................fDr/ ............ ..........................................................................................................................................t................................................................................................... le,e� pA /4gm�ti ................. ............�.................. ..........:.............................. ......................................... ......................... ...................................................... oy TERMS: PLEASE DETACH.FOLD AND ENCLOSE WITH YOUR PAYMENT-KEEP BOTTOM PORTION FOR YOUR RECORDS AMOUNT PAID BALANCE FORWARD ��'�� ........................._5...,tv ' r ......................................................................................................................... . ................ ..... .......... .................. .......... s�` .... . r�r-................................ s..........�........................................................................._................ ............................................... s .........._-� �. �'��.'...............� -�.........�'�.................................. ................ ........... ................... s ........ f/. ........ w' ............> 0/� s ........ ........... ......................... ..............._ct- ___ B. & G. PLUMBING /��/( f(//� PAY LAST AMOUNT whom IN THIS COLUMN TOWN OF SOUTH WINDSOR HEALTH DEPARTMENT Application for permit to install a new/repair subsurface sewage disposal system. To the Health Department, Town of South Windsor. Fee Paid , �.�M Date Permit Number As a subsurface sewage disposal system installer licensed in the State of onnecticut I Name, Address, Telephone Number, License Number hereby apply for a permit to construct/repair a subsurface sewage disposal system located at /moo* &. LLIW MJ A&=_ SD. U)JAJDS0,e_ and owned by Street, Address, Lot Number Name r , Address Information to be supplied by Applicant: Type of dwelling If non-residential, estimated daily flow Residential,Commercial,Etc. Number of bedrooms Size of lole Number of fixtures above basement"- !, S` 5/it1'e_5 /! Tibs,Sink T�iiets,Etc. 4 Number of fixtures in basement, if any �C� Pumped or gravity flow, Type of water supply PJO L) . If private,type of well Public-Private Information to be supplied by Health Department: Soil type at various levels . Percolation rate Square feet of effective leaching area required Size of septic tank Type of system Trenches,Drywelis,Etc. Number of dry wells, trenches, etc. Distance between individual leaching units. Distance from well on same property on adjoining property Curtain drain required Yes,No Height of system above ground water maximum ground water ledge , impervious soil layer If automatic closing is required,description 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 gALTH DEPARTMENT. J� o Permit Received by 8'�5 Date 4gnaturofAppllcaR1&rcenseNu ' er For Office Use Only Permit issued by Date System installed by G ey�5C Final Inspection Approval R dD.ZJ`-29ZZ Date 7- r— 9'g TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT South Connecticut Application for Permit to Install o epair Individual Sewage Disposal System Application No. TO THE BUILDING DEPARTMENT: Date 19 A permit is requested for repair or construction of an individual sewage disposal s tem concerning which the following information is sub. ' ted: 1. Owner of Property 9 Q L Address of Owner Q T L-LI IJA" 2. Location of Property—__-PAN g- J/ Lot. No. 3. Type of Structure /)_ /,6 LL/, .� No. of Bedrooms (Dwelling,Commercial Building,Store,etc.) 4. Number of Families or Persons to Occu y Premises_ 0 I./� l L 5. Plumbing Fixtures: Water Closets Urinals — Lavatories `//,,B--athtubs Showers Kitchen Sinks, Laundry Tubs Garbage Grinder Otherll/ � ,� 6. Liquid Capacity of Septic Tank '7-S �6Material of Septic Tank_�� 7. Soil Conditions: Type of Soil ?A' , c 7 Maximum ground water table Sv (Sand,Grav 1,Clay,etc.) 8. If not served by public water supply: Distance from Owner's well from adjacent wells __Distance to nearest water course, drainage ditch, sto m r 'embankment 10. Percolation Tests: Time for 1" drop in soil test Classi cation of soil L 11. Minimum square feet of effective seepage area required 12. Leaching tem: Nu er of trenches Length Width Total Other L '� s { ! Signature G ( ensed Installer) (Sketch showing all minimum distances and other details required below) CC o � IrZt, r-J ad c s Permit Issued /of LS/ Installation Completed, Inspected and Approved /SJi1 t 19�_ By. gy, S Sop — 1 � Ile U� S""c,ll lv alN NOTES SOUTH WINDSOR HEALTH DEPARTMENT LOCATION OWNER Mic,,4aef TYPE OF WORK ecv -�v cf ca `f�r� lay DATE 7-e -J'9- PERMIT PIPE INSTALLER ",f CA INSPECTOR BY Qi ,