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Home My WebLink AboutSeptic Repair 1510 Sullivan Avenue alawn of OmO ightboar Department of Pollution Control SOUTH WINDSOI. CONNECTICUT DRAIN LAYER' ERMIT ��f- ua Application for Permit to Install or Re '` ual Sewage Disposal System Q.xIiS'�It,.r y-(<�-�.X.. �ry,� by xy�.je-�_ ,��::t•l /'�t.'!t't :. a -/.. %iGt..�c' � ��YY�'• o_. FeePaid $.................................... B f"rf.. .......A... 1.re....................................................................................... Permit No. .....1., ..::.: ..r::............................... lled-�l Date .......I;L- ......................................... Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein for repair ......... or construction ......... of an individual sewage disposal system concerning which the following information is submitted: 1. Owner of Property i.e o 4c ................................... Address of Owner .....LSlo. 2. Location of Property ............... ............................................................................................................................................................ Lot No. .............................. 3. Type of Structure .......................t24A..ALlfu.$......................................................................................................................................................................................................... (Dwelling, Commercial Building, Store, etc.) 4. Number of Families or Persons to Occupy Premises .................0.!tg�................................................................................................................................. 5. Number of Bedrooms .............................................. 6. Average Daily Flow ................................................... Manufacturer and 7. Liquid Capacity of Septic Tank .7.....e��`s?�t`'s'............... Material of Septic Tank .......................................................................................... 8. Soil Conditions: Type of Soil ............: Y.A.,....'/.16.`.`................................................................................................................................................................ (Sand, Gravel, Clay, etc.) Maximumground water table .............................................................................................................................................................................. 9. If not served by public water supply: Distance from Owner's well ........................................................................ Fromadjacent wells .......... ....`.l:,f.................................................................. 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 ......02�.:....It,.brA... ....:,;,.�:........�.zk:. ...L =................................................................ 13. Leaching System: Number of trenches .................:.............................. Length ................................................... Width ................................................... Total ................................................ Other ............ii..r4..1..,/..i,:.>....................................................................................................... 14. Plot Plan Attached. ............................................................... 15. Layout Approved. .................................................................... 16. This permit expires ...................................................................................................... ........... Signature_.. .. .............. . . . -:`�00 /9'�S^ (Licensed Dr er Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances ................................................................................<................................................. 19..2.. ...... By ................................................................................................................................................ Pollution Problem abated Date �. ' ...............:.. :�` ................... .:........................................................... Inspector CONDITIONS I. This permit is issued under the express condition that every person acting under the same shall eonforsn to the representations and conditions of the application therefor and shall conform to and be governed by the ordinances and regulations pertaining to individual sewage disposal systems of the Town of South Windsor including amendments, thereto, and all other pertinent laws, resolutions, ordinances, rules, and regulations of the Town of South Windsor and/or its Sewer Commission, 2. This permit may be revoked at any time. 3. This permit shall be maintained at the site of any work being done under its authority and shall be shown upon request of any authorized person. 4. This permit does not authorize the doing of any acts in, upon or to private property without the consent of the owner thereof. The duty of obtaining such consent and complying with the conditions thereof rests solely on the drain layer and those for whom he acts. 5. This permit does not authorize any excavation in any public street, highway or grounds, or doing any work therein or the placing of any obstruction therein. Specific permission for such shall be obtained from the proper official having charge thereof. S. The Town of South Windsor and its agents assume no responsibility that any repre- sentations in the application for this permit were correct and assume no responsibility for any information furnished or not furnished. 7. At least two hours notice must be given to the Superintendent of the Sewer Department before such Inspector is needed on the work. In general, Inspectors will be available between the hours of 8:30 a.m, to 4:30 p.m. on Mondays to Fridays inclusive. 8. The Drain Layer agrees that he shall at all times indemnify and save harmless the Town and its officers, agents and servants on account of any and all claims, damages, losses, litigation, expenses counsel fees and compensation arising out of injuries (including death) sustained by, or alleged to have been sustained by the servants, employees or agents of the Town, or of the Drain Layer, any contractors employed by him or any subcon- tractor or material men, and from injuries (including death) sustained by or alleged to have been sustained by the public, any or all persons on or near the work, or by any other persan or property, real or personal (including property of the Town), caused in whole or in part by the acts or omission of the Drain Layer, and any contractor employed by him or any subcontractor or material man or anyone direcZ or indirectly employed by them or any of them while engaged m the performance any work covered by this pit and duringanyaintnanceperid speed in aforementioned ordinance. 5 GAY �� sJl�f� � � .3r ! ,�%�d� �'�� i _ i _ _ a t' %�N�'