HomeMy WebLinkAbout1978-3-30 - 161 Carriage Drive - Septic ApplicationMum tit #nno 18inboor
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to nstal or Repair Individual Sewage Disposal System
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FeePaid $ .......... ........... ..........,..0.........................................................................',.......... .......... .................. ........... Permit No. J...7
...........,.....2..............
Date............. ......................
Pursuant to written applicatio , permission is hereby granted to the Licensed Drain Layer named herein
for repair ......... or construction I of an individual sewage disposal system concerning which the following
information is submitted.
I. Owner of Property Address of Owner...:......:......:........................................... ,..
2. Location of Property .-.-_. r+rl 1''.........................................................._..._..........................w .... Lot No. C ........w
3. Type of Structure .................................... 1................................ .... ....... -.-................... .-...::_...........:....:..."..,...........,..:::..........::.....................................
�...
(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 ... ............:.......:.....:.:.....::....... .......... Material of Septic Tank
8. Soil Conditions: Type of Soil .............. _.......... ......-.....-........ .-...-.. ............... ....� ... ..~............,......................
(Sand, Gravel, Clay, etc.)
Maximumground water table........w...............................................................:,..................,.....................
..
.... ......::..
If not served by public water supply:
Distance from Owner's well ................. ...—..........................
...::::,..,.,..:....
From adjacent wells .........::::...::.:.
Distance to nearest water course, drainage ditch, storm drain or embankment ........................ w..,............. ..........
PercolationTests: Time for 1" drop in soil test ........ . ........ ........... ...... ............. - .-..,................ ................ .,....,..,,.................. --.....................
..
Classificationof soil .- ...................................................... ... ................... ................... ....................................................
Minimum square feet of effective seepage area required ..................................................... ::::::.::........ :...,:...:..:.................... ................ :....... ... ............
Leaching System: Number of trenches ............................................... Length .................... Width ................................................
T to ......................... Other
Plot Plan Attached.....-
Layout Approved, ... ...............
This permit expires ...,...... ........................ ........................ _.............
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Signature..-...................................,.._............................-............�...
9.
10.
11.
12.
13.
14.
15.
16.
Installation Completed, Inspected and Approved in acco nee with State Public Health Code and Local Ordinances
_................ .�....................... -
........... 19.........,...... By ..........
._............... ........... ............... _�
PollutionProblem abated Date ...:......::.......... :.......,................................................:...,.:..,.:..,,.::.......:.............. _........_.....
Inspector
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PROPERTY OF RICHARD S. KELLEY
LOT * 39 CARRIAGE DRIVE SOUTH WINDSOR, CONN.
EMIL W. LUCEK ASSOCIATES
NO. I REVISIONS DATE I SCALE I° = 4d DATE II-14-7T
CONSULTING ENGINEERS
5 OAKLAND ROAD
SOUTH WINDSOR• CONN.
203-644-2802
DRAWNA.V.W CHECKED E.W.L
PROJECT 77-152 S5EET
CERTIFIED SUBSTANTIALLY CORRECT - DEGREE OF ACCUR
EMANUEL W. LUCEK CONN. REG. LAND SURVEYOR 6293