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Home My WebLink About1976-10-28 - 130 Buckland Road - Septic Application01ouun of *vut4 10inbsor Department of Pollution Control SOUTH WINDSOR, CONNECTICUT DRAIN LAYER'S PERMIT Application for Permit to Install or Repair Individual Sewage Disposal System Fee Paid $.--.- .. .. By Permito. ,.. z.................................... Date ............ ....1-1-7.....CO...... 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 ...........................................................................-...................... -- ............ .....-.-...--............ ...-... Lot No. .............................. 3. Type of Structure.....................................................:............................ ._................................................. ............................................................................................... (Dwelling, Commercial Building, Store, etc.) 4. Number of Families or Persom to Occupy Premises .................. ....................................................... ........... ...... ,...,„..... 5. Number of Bedrooms .... �)� 6. Average Daily Flow ............... . Manufacturer and 7. Liquid Capacity of Septic Tank ..%a�.��'..C� ..--....- aterial of Septic Tank . ..... �r'-.,..,......... ......... ............... 8. Soil Conditions: Type of Soil ...........,-.......�i...:...................................................................... .................... .............. . (Sand, Gravel, Clay, etc.) Maximum ground water table ..... Q ............w....:� 9. If not served by public water supply: Distance from Owner's well 7u� p.. (.. ..... . From adjacent wells ... .. 10. Distance to nearest water course, drainage ditch, storm drain or embankment .. ...... ........:........... ............................ ................... .... ...... 11. Percolation Tests: Time for 1" drop in soil test ............. -..:.,... Classificationof soil .. .. ................ .............. ........................................ ...... ......................................-....... ....................I— 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 .. . . ..... (Licensed Drain Layer) Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances ....._..................... ............................... .... 19.... By Pollution Problem abated Date .... ..................... ......:............ ...... M...._....,................_..................................................................._......................... Inspector I N lof ep cz r d 10' 0 d►a� D 3 v � 4 �D IjS09�1 Vol Lot l0' to d SCANNED NOTES TRe_NLcV,6s : 30 k-o&e% La4e SOUTH WINDSOR POLLUTION CONTROL gqp' L\,,Qar qec{ LOCATION 136 g7 S Saoam Sock OWNER TYPE OF WORK %grm►r s w%c .DATE0C9ovkq,jk PERMIT PIPE INSTALLER s� INSPECTOR DRAWN BYPeTe