HomeMy WebLinkAbout1978-6-15 - 1509 Ellington Road - Septic ApplicationZinn of OvW4 10inbsor
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S PERMIT
Application for Permit to tall or Repair Individual Sewage Disposal System
Fee Paid ............ By 7 Permit No. ...... A
Date.......... .......................
Pursuant to written application . permissI
ion is hereby granted to the Licensed Drain Layer named herein
for repair or construction X of an individual sewage disposal system concerning which the following
information is submitted:
1. Owner of Property #E.A.Nfi!�-r ......... 6MAS1hFA-'J?FAddress of Owner . ..................................................................................................
2. Location of Property ..................... 10 0.9 ........... 9k4z#V..Q rOAN ............ R-6111P ... I .................................................. Lot No . ..............................
3. Type of Structure ....................... ......................... .. ........................................................................................................................................................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ............... PWO ....... ......... . .. . ...... . .. .....................................................................................
5. Number of Bedrooms .......... J ..............................
6. Average Daily Flow ...................................................
Manufacturer and
7. Liquid Capacity of Septic Tank ...... ... Material of Septic Tank ... A-9-fl.b.0 ...............
8. Soil Conditions: Type of Soil .......... ............. cv."ey ............................... ..... bl ;U-� .......... ..................... ................. ............. -
(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 I" drop in soil test .......... - ................................ . ..................... ......................... -- - ........... ...... ....... .........................
Classificationof soil ................. .................. . ............................... ................. ......... .......... -.- .... . ...............................
12. Minimum square feet of effective seepage area required — .. . .... . ....... ................. . ................ . ........................................... .. . ............
13. Leaching System: Number of trenches .... ........ . .. ......... . . . ........ Length Width ........... .........
TotalOther ....... . ............... - --- ------ . ........ . .. . .................... .............
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
.................. ................... /f ..................... 19... 7
By ......... ......................... I ............... I ..........................................
Pollution Problem abated Date.................. ..........................
...................
Inspector
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NOTES
i +� Sept;
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which was cu�,s.l�-ucFec( � brick,
LOCATION 150g fZWVGTDrV A'DAU
OWNER ER AI ES7" GU14S7L4 Fi6'RRD
TYPE OF WORK SEPTIC S yS 7SM
DATE 6-/5-70 PERMIT A8-Z&APIPE
INSTALLER COVEN eoAISI,CM CT/D4
INSPE[:TOR �P 1..=fJ . DRAWN BY r. T
Down of 1- 4W4 11inboar
Department of Pollution Control
SOUTH WINDSOR, CONNECTICUT
DRAIN LAYER'S ?6 R C- ?'E S--I--
Application for Permit to Install or Repair Individual Sewage Disposal System
Fee Paid $..................... By ...,,.M/L.............. L.uG.IK........................................... Permit No. ..... .. ..
Date.............. .. z..... .... .........
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 A ess of Owner ................. :...:.... .. ..............1,
2. Location of Property �I n .1 .a. 7..... .........e GL..............._......................................... Lot No. ..............................
3. Type of Structure _..... .......... .._.. ........................... .......,.................... .....,,........................ ...,.......................................................... ......................
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises .................... O N.Ag�..........._........................::............:....:..::....................,.....,.........................
5. Number of Bedrooms ......... _:,..-. ........ ...:..........
6. Average Daily Flow ......._....
Manufacturer and
7. Liquid Capacity of Septic Tank .............................._.._._........._ Material of Septic T nk,................................................................................. .
8. Soil Conditions: Type of Soil,,,...CC........0.'.........!...........Q.f.........Ia.[�4...1.�1�i�'..r........�.E.'1.......IUaS......4I'I .
(Sand, Gravel, Clay, etc.)
Maximum ground 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 r 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 ......- Length ...,......,...,,.................................. Width ......—......._..............._..........._
Total ✓,,. Other ....... .....................
............... ..........................
14. Plot Plan Attached. .. .........
15. Layout Approved . ..............::... _.. .......,
16. This permit expires ......... ................ ................. _................................................................
Signature..... ' .......... 7 ...,.,..._..................................................
(Licensed Layer)
Installation Completed, Inspected and Approved in accordance with State Public Health Code and Local Ordinances
.......... 1. ......................./Z............. .....,.,.............. 19..16L. By ......... .......... ,.......................
Pollution Problem abated Date _.., ........_.................. Inspecto, r w
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