HomeMy WebLinkAbout2012-3-31 - 126 Brook Street - Septic Approval LetterTown of South Windsor — Health Department
1540 Sullivan Avenue, South Windsor, CT 06074-2786
Phone: 860-644-2511 ext. 248 Fax: 860-644-7280
APPROVAL TO CONSTRUCT OR REPAIR SEWAGE DISPOSAL SYSTEM
Approval is hereby granted for the construction/repair of a subsurface sewage disposal system
at the property described below:
PROPERTY OWNER(S): David Kaminski
STREET ADDRESS: 126 Brook Street TOWN: South Windsor
INSTALLER: Andrew Coleman CT. LIC # 5839 EXPIRES: 03131/2012
RESIDENTIAL: # of Bedrooms - 3
INSTRUCTIONS FOR INSTALLER
1. Construction plot plan submitted and approved by this office must be adhered to.
2. This office must be contacted for approval if any change is going to be made in the system
location, size or design, or any changes in house, well or property line locations.
3. Any NEW sewage disposal system must conform to ALL requirements of Section 19-13-BI03 of the CT
Public Health Code.
4. ALL new construction to be under DIRECT supervision of a CT licensed installer under Section
20-341 of the CT General Statutes.
5. The installer is RESPONSIBLE for VERIFYING LOCATIONS of PROPERTY LINES, WELLS,
and BURIED UTILITYLINES prior to construction.
6. Installer to notify South Windsor Health Dept. 24 hours prior to the start of construction.
7. Installer to have septic tank covers removed at the time of inspection.
SPECIFIC INSTRUCTIONS:
SEPTIC TANK AND SEWER LINE REPLACEMENT ONLY
1. Install per approved plan, (Andrew Coleman, Dated: 11/01/2011).
2. Install a 1,000 gallon two compartment septic tank, with an approved outlet filter. Risers are to be installed if there
is to be more than 12" cover over septic tank cleanouts.
3. Installer to schedule, and be present for final inspection with Health Dept. staff. Level to be set up for verification of
elevations OR an engineer's/surveyor's as built will be required.
4. Installer to complete and submit septic system as built plan and drawing with ties to the house.
5. Existing septic tank to be properly abandoned.
SIGNATURE: 4te� DATE ISSUED: 11/21/2011 RENEWAL: 1_I
APPROVED BY: Robept a, RS EXPIRES: 11/21/2012 EXPIRES: 11_
THIS PERMIT IS VALID FOR A PERIOD OF ONE YEAR FROM DATE OF ISSUE. IN ACCORDANCE WITH THE CT PUBLIC HEALTH CODE
SECTION 19-13-BI03e(F)(1). ONE RENEWAL IS POSSIBLE PROVIDED SOUTH WINDOR HEALTH DEPARTMENT IS NOTIFIED PRIOR TO
THE EXPIRATION DATE NOTED ABOVE. IF PERMIT EXPIRES, INSTALLERS ARE CHANGED, OR ANY OTHER DEVIATION FROM THE
ORIGINAL PERMIT, A NEW APPLICATION MUST BE COMPLETED AND ALL APPLICABLE FEES MUST BE PAID.
FEE PAID:10.00 CHECK # 6001 DATE PAID:1111712011
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