HomeMy WebLinkAboutSeptic Repair 125 Troy Road H
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Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT`
DRAIN LAYER'S PERMIT
Application for Permit to Install 0 1 epair dividual Sewage Disposal System
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Fee Paid By ............ .: .. ......C:. ........................................................................................ Permit No. ......Y:..::
Date .............c.?..`.1..:.......
....................... ..............
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 Address of Owner .....":.:::.....":.`:`'.:` ...`
2. Location of Property ..rl!,A!;^s...............:.............................................................................................................................................................. Lot No. ..............................
3. Type of Structure .......+.=��'. 7: �k
..... ............................................................................................................................................................................................................................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ................................................................................................................................................................
5. Number of Bedrooms .....................
....{%.......''..................
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank .... ` '..'.::'... ' 1 ........ Material of Septic Tank ........ '.1.::.:rk ..........................
8. Soil Conditions: Type of Soil ..............................
:.r�,. :?Y........:>.::....:5/?/'.'.........................................................
...............................................................................
(Sand, Gravel, Clay, etc.)
Maximumground water table ...............................................................................................................................................................................
9. If not served by public water supply:
Distance from Owner's well .......... ::j....:.........::.....::.............................
Fromadjacent wells .............................................................................................
10. Distance to nearest water course, drainage ditch, storm drain or embankment .......................................................................................
11. Percolation Tests: Time for 1" drop in soil test ..........................,r 'f.".f'.. .:r:"... ' ':: r
Classificationof soil .............. :!a:::.:.:'.ri>...................................................................................................................................................................
12. Minimum square feet of effective seepage area required ...................................................................................................................................................
13. Leaching System: Number of trenches ................................................ Length ................................................... Width ...................................................
Total ................................................ Other ......:.....6.4`Z9.........................................................................................................................................
14. Plot Plan Attached. ..............'':`................................
..........
15. Layout Approved. .............�...: ..........................................
16. This permit expires ....::.,.;.. .;.r.,,.....:%;.......V. ..................................................................
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Signature ,, ..............
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........... ..... ....................................................................
i (Licensed Drain Layer)
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
,t By
Pollution Problem abated Date ..................... .::............................................. ............`...:.... ...........:..:;...............
Inspector
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-SYLVIO PARADIS -
PLUMBING R HEATIN' a
17 BROOKFIELD St. ;
SO. NINDSOR CONN,
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