HomeMy WebLinkAbout1972-12-14 - 135 Hillside Drive - Septic ApplicationGama nf $mrth 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 .he..No......3mm ................................................................................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:
l.Owner of Property ..................................................................................................Address of Owner
2.Locatlon of Property .............................................................................................................................................................................................Lot No ..............................
3.Type of Structure ...............................................................................................................................................................................................................................................................
(Dwelling,Commercial Building,Store,etc.)
C301kr
From adjacent wells .............................................................................................
10.Distance to nearest water course dramage ditch storm dram or embankment
ll.Percolation Tests Time for l”drop 1n sorl test ..............................................................................................................................................................................
Classihcation of soil .................................................................................................................................................................................................
12.Minimum square feet of eEective seepage area required ...................................................................................................................................................
13.Leaching System:Number of trenches F0ur(ff)..................Length ..........125fto .................Width ...................................................
Total 5.5.qft..........Other .........................................................................................................................................................................
Plot Plan Attached................................................................
Layout Approved....................................................................
This permit expires ..................................................................................................................
l4.
l5.
16.
Signature ..................................................................................................................................................................................
(Licensed Drain Layer)
Installation Completed,Inspected and Approved in accordance with State Public Health Code and Local Ordinances
Pollution Problem abated Date O5JanuarYv1973
Inspector
...........................................................................................................................19 ..................By ...............................................................................................................................................
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 .tee.
Soil Conditions:Type of Soil
(Sand Gravel QMaximumgroundwatertable.........................................................................f‘If not served by public water supply
Distance from Owner’s well
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NOTES
Scale =’+O'in 1"approx.
A w.29 %5B2751+
SOUTH WINDSOR POLLUTION CONTROLLOCATION135HillsideDrive
OWNER Anthony ForghettiTYPEOFWORKSepticReyair
DATE 01~05-73 PERMIT 72—1oi+PIPELw 0.3.INSTALLER Adam (w9—2o6559)INSPECTOR ME DRAWN BY ME