HomeMy WebLinkAbout1972-8-11 - 117 Dart Hill Road - Septic Repair Application0ntrrt of #vut4 Wittbour
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to Install or Repair ,Individual Sewage Disposal System
Fee Paid $ ... . . ByB.o..gf.fard....Qk�e.ak....N.o- 3.9Q.7.......................................................-... Permit No..........................................................
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 ................................. ................. .... .......................... Address of Owner ........... ..-.--.- ......- ..-- ...........
2. Location of Property ............ ... .... ............... -............ ..................-,..,..,..,.................... .....,....-..... :..:.........:...................... Lot No. ............... w........... ..
3. Type of Structure .... ................ ......................... ..... ......... --- ......... ....................................................... ............ .................................... .,.....-.-.....,...,...,,.,.............
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ................................................
5. Number of Bedrooms ................... ............
6. Average Daily Flow .........................................
Manufacturer and
i Liquid Capacity of Septic Tank ....... ........................................ ... Material of Septic Tank ................. .........
....,...
SoilConditions: Type of Soil ................................. ... --................. _............. ........... ... .,.,....................
(Sand, Gravel, Clay, etc.)
Maximumground water table ........... ......................................................................................................................................................... ..
9. If not served by public water supply:
Distance from Owner's well
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 .. M........... ........ ............ ..... ....................................... ........................
12. Minimum square feet of effective seepage area required.......................................................,...............................
13. Leaching System: Number of trenches Width ....................... Length ....................... • . ..... ,.. ............. .,.........,.,....,.,.
Total ......... -. Other 40.-f..t.....equal.izi.er...,treneki...ins.tall.ssi....aexe.ss....pari.+....of
14. Plot Plan Attached . ...... :.............. .......... .... ....-...,,.. front yard.
15. Layout Approved. ......... --..................................................
16. This permit expires .................... .........................-.....--..................... ....................... .................
17. Reference Pollution Complaint 13-72.
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 ......1..1....Au tst..,.....1.972. Melvin Edwards, Jr.
Inspector