HomeMy WebLinkAbout1977-6-24 - 130 Hilton Drive - Septic Application@nmn nf §7nmh minhanr
Department of Pollution Control
SOUTH WINDSOR,CONNECTICUT
DRAIN LAYER’S PERMIT
AApplicationforPermittoInstallowoi'/Individual Sewage Disposal System
Xx 15":Fee Paid $.....‘/By .............................................................................................................................................Permit No.............................”..‘............................
Date ...........................................................................
Pursuant to wrltten apphcatlon permissmn ls hereby granted to the Llcensed Dram Layer named herein
for repair x or constructlon .........of an 1nd1v1dua1 sewage disposal system concernmg wh1ch the followmg
information ls submltted.
l.
2.
3
10.11.
12.
l3.
l4.
15.
16.
Plot Plan Attached................................................................
Layout Approved ...................................................................
This permit explres ................................................................................................................
(Licensed Drain Layer)A”,543/2
Installation Completed,Inspected and Approved in accordance with State Public Health Code and Local Ordinances
By ...............................................................................................................................................(i?f€/¢?L/(?$/77
Inspector
Pollution Problem abated Date ..............................................................................
/an
Owner of Property ........................................................................Address of Owner .............A...........'...........i
Location of Property ..........(E;-.........................................................................................................................................................................Lot NO
Type of Structure ...................................................b ...........................................................................................................................................................................................
(wellmg,Commercxal Building,Store,etc)
Number of Families or Persons to Occupy Premises ................................................................................................................................................................
Number Of Bedrooms ................................................
Average Daily Flow ...................................................
Manufacturer and
Liquid
Soil Conditions:
Capacity
Type
of Septic
of 8011
Tank
..............................
.....................................................CfgW ..aterr C?1 of Sepuc Tank
(Sand,Gravel,Clay,etc)
Maximum ground water table ............................................................................................................................................................................
If not served by public water supply:
Distance from Owner’s well ........................................................................
From adjacent wells .............................................................................................
drain embankmentDistancetonearestwatercourse,drainage ditch,storm or
Percolation Tests:Time for 1”drop in soil test:...........'............'........................................................................................................................................................
Classihcation of soil .......................................................................1
Minimum square feet of eEective seepage area required ...................................................................................................................................................
Leaching System:Number of trenches ................................................Length ...................................................Width
Total ................................................Other
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