HomeMy WebLinkAbout1977-12-19 - 189 Brookfield Street - Septic Applicationilowrt of ,a tn�l nx
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit Install or Repair Individual Sewage Disposal System
Fee Paid $. - By �.. .. Permit No. J
............................................................................................ :,.............. /
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 ..4, ......:.::- .................. Address of fi ner ... rr ......,.
2. Location of Property.........�c�............ Lot No.._1.............
3. Type of Structure........................................................................... ? r 1.1.;'.....................................................
(Dwelling, Cc ercial Building, Store, etc.)
4. Number of Families or Perso to Occupy Premises .................... .............. ............... ..::.....::.....::...:.:....:....:.
5. Number of Bedrooms ............... ........,.....,,..,.
6. Average Daily Flow ........................................... _.....
Manufacturer and
7. Liquid Capacity of Septic Tank Material of Seiptic Tank ............. .......... .... ........... ............
..
8. Soil Conditions: Type of Soil .......... ...,:............ .............................:.......:.:............' ..................:................. I..... ...... ..._..,... ...... ............. ...................
(Sand, Gravel, Clay, etc.)
Maximumground water table :::. .. ....................... ......................... ........................... .................,................................
9. If not served by public water supply:
Distance from Owner's well ......................................................................
Fromadjacent wells .......... ....... .................. ........... ..................................
:.....::....
10. Distance to nearest water course, drainage ditch, st drain o mbankment........._.._._....._................................................
11. Percolation Tests: Time for 1" drop in soil test ..........,.�P,, ... ,l . .�.. �......... f............................................._.................
Classification of 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.„
16. This permit expires..............................................................................................................
Signature .. ,.....,, ...�\.. `J......y.......................... ., ...... , ......................
...(..'. .... ......
-; (Licensed Drain Layer)
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
.. L........ ...:......................... _.............. 192.2 By ...... __............ ..................„...........,...........,,...................................................,.,....................
Pollution Problem abated Date ................... --.............. .................... .................... ....../..:'! `.:L.�. .............:..... , .........� _....__......
Inspector
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PROPERTY OF
R. J. A L EWA N D E R� IN C.
BROOKFIELD ST—SOUTH WINDSOR,
CONNECT/CUT
SCALE! /"x 40' SEPT. 29, 1977
JAME5 E. SHFEHY L.S. 7034
REV sEpr1r- sysr,-m
OCT 15, 1977
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