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Home My WebLink About2008-12-29 - 110 Ident Road - Septic ApplicationTOWN OF SOUTH WINDSOR HEALTH DEPARTMENT Application for permit to instaH a new/repair subsurface sewage disposal system.To the Health Department, Town of South Windsor. Fee Paid Date Permit Number Address Information to be supplied by Applicant Type of dwelling 1'e m fig/ m I?v i Number ofbedrooms ,7;Size of lot Number of fixtures above basement Number of fixtures in basement,ifany Type of watersupply f A.,jJ "’.If private,type ofwell Residential CommerCial Etc .If non-residential,estimated daily flow Tubs,Sinks,Toilets,Etc‘ ! Pumped or gravity flow, Public Private Information to be supplied by Health Department: Soil type atvarious levels Percolation rate Size of septic tank Trenches,Drywells,Etc. Number of dry wells,trenches,etc.Distance between individual leaching units.Distance from well on same property on adjoining property Curtain drain required Yes,No Height of system above ground water ,maximum ground water ledge ,impervious soil layer lf automatic Closing is required,description .Square feet of effective leaching area required Type of system l A PLOT PLAN INDICATING LOCATION OF PROPOSED STRUCTURE,WATER SUPPLY,SEPTIC SYSTEM,EM- BANKMENTS,WATERCOURSES,PROPERTY LINES AND ALSO INDICATING EXISTING AND PROPOSED FINISHED GRADES MUST BE SUBMITTED BEFORE THIS PERMIT CAN BE ISSUED. THIS PERMITIS NOT TRANSFERRABLE FROM PERSON TO PERSON OR FROM PLACE TO PLACE. NO PART OF THE SYSTEM SHALL BE BACKFILLED UNTIL IT HAS BEEN INSPECTED AND APPROVED BY THE SANITARIAN. SPECIFICATION AND REQUIREMENTS AS STATED IN THIS PERMIT MUST BE MET AND ANY CHANGES MUST BE APPROVED BY THE TOWN SANITARIAN BEFORE FINAL APPROVAL WILL BE GIVEN. THIS PERMIT SHALL NOT BE CONSTRUED AS PERMISSION TO CREATE A NUISANCE CONDITION NOR IS THIS SYSTEM GUARANTEED BY THE HEALTH DEPARTMENT. Permit Received by Date l;"g9‘0 f ignature ofApplicant &Lice s Number For Office Use Only Permit issued by Date / System installed by Final Inspection Approval Date As a subsurface sewage disposal system of Connecticut, :{Z‘Lirzy k >54 wry}g1 L/.zimb QD ii iii:33(H5y /é/ :{I;,.ti: §;::i!f,0/,1”;/ Name Address,TelephoneNumber,LicenseNumber hereby apply for a permit to construct/repair a subsurface sewage disposal system located at [/g/;-/jl1 I f J andowned by i7;/,://vu\ Street Address Lof Number Name [325»,9:bii;a¢;"‘£9?)fixtu';’ff/L35;AuV/i}:’;;(x a"iff’ 1540 SULLIVAN AVENUE o SOUTH WINDSOR,CT 06074 TELEPHONE (860)644-2511 Septic System As-Built Plan Street Addr ess ///()J&M&KL&/Date £72 3&1}8 Permit Number .'New Septic System 'Repair of Septic System Alteration of System Number of Bedrooms 6 or Desigr Flow of Building Type of system installed ixl s r/N é (e.g.stone trenches,infrltrators,galleries) Square foOtage of system:Total length 5X6 7/I“(I Width 'EffectiveArea €Xl5r/N0’-SiI Capacity ofTank /5 0 (D New 1/Existing Length of house sewer pipe 0 /W123 [Jab gdav/a/e $’0 I M §t”g’§x Minimum distance between septic tank and foundation Minimum distance between leaching field and foundation Q2 O I Minimum distance between sewage system and nearest well '7//é [I Public water supply Minimumdistance between leaching system and property boundary £X '5 /7 /\(ée Curtain drain required?Yes i No / Minimum distance nom leaching field t0 drains {/Xr S /‘/N& (curtain drain,foundation,stormwater,etc.) J Septic System As-Built Plan Address //0 jé/f/77’?0/??9 Dat€/23%)’0‘8 Location of System gCLL‘JL (N,S,E,W,front,back side ofhouse) Drad a substantially correct drawing showing separation distances of the septic systeminstallation.Include all of the following information to provide an accurate record of the entiresystemlocation: At least two sides of the building nearest the system,septic tank,house sewer,distribution boxes,trench ends,dry wells,curtain drain,potable water supply wells and any other features affectingthesystemanditslocation. Installers Nameiwqpgg$wWW—‘MljcenseNumber‘W Installers Address ét/5ELD 72%Mn?ML (street,city,state and zip code) am e/7/ Distance from comer A Distance &om comer B Distance from comer C Distance from comer D 1540 SULLIVAN AVENUE o SOUTH WINDSOR,CT 06074 TELEPHONE (860)644-2511 PERMIT TO DISCHARGE Approval is hereby given to 110 Ident Road,in accordance with the Public Health Code,Section 19-1 3-BIO3e (h)to discharge to a subsurface sewage disposal system located at 110 Ident Road, in the town of South Windsor,CT,that will receive treated domestic sewage from a: Three (3)Bedroom residence Permitted Volume/Design Flow =375 Gallons per day *In orderto provide a sufficient factor of safety,it is recommended that the average daily discharge not exceed 2/3 of the design flow or 300 gallons per day. Operation and Maintenance:The septic tank shall be inspected regularly and cleaned as needed but not less frequently than every five years.The septic tank has an effluent filter. Effluent filters require periodic cleaning.Failure to clean the filter could result in a backup of sewage into the building or effluent breakout. Special Requirements and Restrictions:1.Wastewater (backwash)from a water treatment system cannot discharge to the subsurface sewage disposal system.2.Use of a kitchen garbage disposal is not recommended.3.Signs of malfunction or failure should be addressed. Exceptions: Distance from well to septic tank 71 ’6” Date of Final Inspection:December 30,2008 Inspected by:Robert De Vito,R.S.Environmental Health Officer Signature:Date: AVERY CONSTRUCTION,LLC.64 FIELD ROAD UNIT 1A SOMERS,CT 06071 PHONE 860—749-9356 FAX 60—749—15248 POint #1 #2 #3 #4 #5 #6 #7 #8 #10#9 Distance a Q; " from “A”M3 'I- Z{13$}?gi 27¢f 7 r’‘4‘ Distance from“C” Distance fx‘om"D”