HomeMy WebLinkAbout1975 - 22 Chapel Road - Septic ApplicationcTntun of OLW4 Vinbsor
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
Fee Paid $........ ..20.00....) E .try. ... Building ...Department .................. ....... ......................... :............ Permit No.............................................................
Date................. ---- .._.................................. .
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein
for repair .......,. or construction XX.. of an individual sewage disposal system concerning which the following
information is submitted:
Linda F. &
1. Owner of PropertyCASSARINO, Salvatore....P.................... Address of Owner .....22....Chapel...Road...........................................
2. Location of Property North, side......between,..Main,,,Street.,,& Route. 5....................................... Lot No...............................
3. Type of Structure ................Dwelling .........
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ........... Q.ne......1......f i.Iy..:......t.......................................................................................
5. Number of Bedrooms .....Thr.e ....-B).....7! per attached plot plan
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank 1..e000....gallons........... Material of Septic. Tank..........................................................................................
8. Soil Conditions: Type of Soil .See,Attached.,, Soil Test,...Reporti
(Sand, Gravel, Clay, etc.)
Maximum ground water table None encount
..................ered...................................................................................................................
9. If not served by public water supply:
Distance from Owner's well ................. .. ......:.....................,-
Fromadjacent wells ......:......:..................... ......_,,.................. .............................
10. Distance to nearest water course, drainage ditch, storm drain or embankment ............... ................... :._.-:....:,...... _.,._.:....:::-------
11. Percolation Tests: Time for 1" drop in soil test........Axerage....=.....1.'......i..T.1 1..,5.....Mia. u.te.a....................................................................
Classificationof soil ............................................................................................................
12. Minimum square feet of effective seepage area required 1R5_9q,,,ft,,,,per..,bedroom...... to.tal.,..of...325,,,,sq,,,,f,t.
13. Leaching System: Number of trenches ................ ............ Length ............... ............... ..................... Width ..,.,,....................... ............ ..
Total ..............................,...,.......... Other .....,............. ...................... ................... .,....m...........,...... ,.... .._.......... ............ ... .............
,..........
14. Plot Plan Attached. .......Yes .............................................
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
w........_......_........................ ................. ......._..._....... _........... . 19.................. By ..... ........... ......................................................................................._............. ........ .-........-..
Pollution Problem abated Date ............................................... ........... ....
......
Inspector