HomeMy WebLinkAbout1982-8-6 - 215 Lawrence Road - Septic ApplicationEngineered Systems -Pump Systems —Our Specialty
Septic Tanks Vacuum Cleaned
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SEPTIC SERVICE
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TOWN OF SOUTH WINDSOR
f~HEALTH DEPARTMENT
ppli¥ation for permit to install a new/iiepairr23ubsurface sewage disposal system.To the Health Department,
T wn fSouthWindsor.
Fe aid Date Permit Number
Address
Information to be supplied by Applicant:
Type of dwelling .If non-residential,estimated daily flow
N umber of bed rooms Size of lot
Number of fixtures above basement
Number ot fixtures in basement,ifany
Type of watersupply .If private,type ofwell
Residential,Commercial,Etct
Tubs,Sinks,Toilets,Etc.
Pumped or gravity flow,
Public-Private
Information to be supplied by Health Department:
Soil type atvarious levels
Percolation rate .Square feet of effective leaching area required
Size of septictank Type of system
Trenches,Drywells,Etct
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
ledge
,maximum ground water
,impervious soil layer
If automatic closing is required,description
I
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 PERMIT IS 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.
Asga sybsurfa’ge sewage,’dispgsal system i/nstalier licei'tsed in.the State of Connecticut,if‘I'Vigdi’S?F bgi/.‘W;Q'1/g g’g]Wait;if‘im'/irlx iffi‘it/i‘ihvf fix/23 2?]3 ,Jzwfgf'Wl TeiephoneNumber,Name,Address,LicenseNumber
hereby apply for a permit to construct/repair a subsurface sewage disposai system located at
2/3“Lxmxrmvw Mr)fit andowned by k/I'VVr/(zi/Ig
Street,Address,Lot Number Name
(2%”
/,i
Permit Received by I XI NI (At/I 'Date
Signwa%re of Applicant &License Number r,
For Office Use Only
Permit issued by ,4?,v agla/lurkf
/Date y ~'(f;"K7;
System installed by
Final Inspection Approval I»?’(/99,g/L/L/fr?J Date Ewe/23’5L