HomeMy WebLinkAbout1975-7-3 - 236 Foster Road - Septic Application@nwn nf $nmh minhanr
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 .................................................................................................................................................Permit No.............................................................
Date ...........................................................................
Pursuant to written application,permission is hereky 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:
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2.
3
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l3.
Total ................................................Other .........................................................................................................................................................................
Plot Plan Attached................................................................
Layout Approved....................................................................Sc gqMVira14.
l5.
l6.This permit expires ..................................................................................................................
Signature ..................................................................................................................................................................................
(Licensed Drain Layer)
Installation Completed,Inspected and Approved in accordance with State Public Health Code and Local Ordinances
Pollution Problem abated Date .........................................................................................................................................................................................................................
Inspector
..........................................................................................................................19 ..................By ................................................................................................................................................
Owner of Property ..................................................................................................Address of Owner
Location of Property .............................................................................................................................................................................................Lot No.
Type of Structure ...............................................................................................................................................................................................................................................................
(Dwelling,Commercial Building,Store,etc.)
Number of Families or Persons to Occupy Premises ................................................................................................................................................................
Number of Bedrooms ................................................
Average Daily Flow ..................................................
Manufacturer and
Liquid Capacity of Septic Tank .........................................................Material of Septic Tank ...............................................................................
Soil Conditions:Type of Soil .............................................................................................................................................................................................................................
(Sand,Gravel,Clay,etc.)
Maximum ground water table .............................................................................................................................................................................
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
Percolation Tests:Time for l”drop in soil test ...............................................................................................................................................................................
Classihcation of soil ...................................................................................................................................................................................................
Minimum square feet of eEective seepage area required
Leaching System:Number of trenches ................................................Length ...................................................Width
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PROPTRTY OF
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Scale 1 "-50' yar.1 ,1 965
Note:
$zil._tling built as shown
Thore a-e no violatibr. of
the zoning ord inane -ea .
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