HomeMy WebLinkAbout1993-6-18 - 18 Long Hill Road - Septic ApplicationTOWN OF SOUTH WINDSOR
H/EAITH DEPARTMENT
Appllcatlon for permit to mstall a new/rgpalr subsurface sewage dlsposal system To the Health Department
Town of SouthWIndsor
Fee Paid Date Permit Number
a,subsurface sewage dlsposa|system InstaHeL lIcensed In the State of Connecticut,i
Vidctta KM taskerak$uns éw harm 9’East tarHmt QW 3%#073
Name bfu m Whsi‘Address TelephoneNumber LicenseNumber
ereby apply for a permrt to construct/reparr a subsurface sewage disposal system Iocated at
in Luna fl“‘QdncJov‘f’1\(i‘rndar‘andowned by mfr‘m’mréi R Li bhu
street Address Lot Number Name
H:LfWmHtH pA .wo’rh Uund‘w‘w
Address
Information to be supplued by Appllcant .
Type of dwelling F (i at (hnt’u 61!
Residentrat Commerc1al Etc
.If non-residential estimated daily flow
Tubs,Sinks,Toilets,Etc‘
Pumped or gravity flow,
Type ofwatersupply IJV l \f €l~+¢.lf private,type ofwell V frér—€2iar\Li)€,H
Public-Private
Information to be supplied by Health Department:
Soil type atvarious levels
Percolation rate
Size of septic tank
Square feet of effective leaching area required
Type of system 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
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 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.
Permit Received by%¢w s iw
Sig’nature of Applicant &Licene Num
9&93 Date é ’/.?"’?3
ForOffice Use Only
Permit issued by Date
System installed by ,
Final Inspection Approval ell/iig/éké,Date
Numberofbedrooms 3 Sizegflot i3 )K
Numberoffixtures above basement wQ 5st n K3}-l l ub I,
l l u:l€+
Number of fixtures in basement,ifany MO h é,,
wwm.w .—-.-w rm“.»
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NOTES SOUTH wINDsoR HEALTH DEPARTMENT
LOCATION 3 ('3
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TYPE OF WORK v 81M;w
M§1‘93 PERmT PIPE
INSTALLER f‘v I V6;kir“
INSPECTOR mg‘k
Lew/5 Hill GM,
LOCATION ;v Law/x .a .V i x i BC
OWNER WVr hard¢%rhx a-«Fr 9mg:
TYPE OF WORK Ram,w
DATE é~ll-CI3 PERMIT PIPEINSTALLERfvl1/6;kw
INSPECTOR ROD DRAWN BY Q4)
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NOTES SOUTH WINDSOR HEALTH DEPARTMENT
V".f:SOUTH WINDSOR HEALTH DEPAK'IMbNl ”yugAfiww :30.K‘A.‘I‘r;
MGATICH FOR SEVAGE DISPOSAL SYSIE’!{(6,7gb
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mmou Tm:(Recm m.tens)fawn?)son.mxsmaz:
bate;.
¢¢1;Lsdge At water At ‘“.33Degth
5 r3 c:Mei/P5 c:f 5th?
m mamas
Rom #1 g m #2 3cm #3 m it
Tim Reading Tine Reading Time Resting Time Readim
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5316‘‘3 Grcund water Mia:
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Ground -Soil
FORM #9 SOUTH WINDSOR HEAL‘mDEPARTMENT
5mm CONDITIONS
astem desig large:than 2,000 g.p.d.Water supply 'atershgd
agh grannd.vgter (less than Lté-ft.)Possible season].highmumwter
watercourse,msh or pond
Mud.suitable are;Slope over 15%“
ran-goal soil (3O -60 ms./inch)Shallow ledge (less than 7 rt.)
underlying tight soil (less than '+rt)Other
$HVۤuwbLVH_;u{933%:v wgww.3wt
Possibla seasonal flooding
COMUSI ON
suitable to:sewage disposal
Unsuitable for sewage disposal
Additional investigtion required
Retest during wet season
mer's ylan required
DEG}:REWTDATIONS x
W j’@‘7
lkwmVigfll $7);
§‘,y§1}Lek A 1:9 Mfv‘owx /K?wié owe
Investigated by ,y/Title
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Confined/Witnessed bye /f‘}Title a/0’31 ini'ry
Comments:
Bench.mrk location Elevation
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Fom #1 SOUTH WINDSOR HEALTH DEPARTMENT~
AFFLICATION FOR PM TO CONSTRLET OR REAIR A SEWAGE DISPOSAL SYSTm
(Office use can)APPLICATION NO.
TO TE DIRECTOR OF HEALTHTOWNOF
Application is hereby mde for permit to construct a.sewage disposal system for a
es ence,Store,Re .v
I X Lcwxs’,HMJ {5d
(street Address,Lothuber,Subdivision Name;Map,Block,Int,EfCt )
New system Addition Repair a/othe r
Te1.Noa $23 55;?$3
TeloNOQ Q KOI ‘2‘r éé
Installer License No.
1n accordance with detailed information stated below
nATE é I ff—L?’‘3
Owner '(§f/é71.-al~«i&i-Elv’a K wily?Address [0 Lcht)HJH w
Installer fvIWf-Jvr Address
Etc.
Located at
\
Siped
A_plication fee paid if as ,(Owner or duly authorized representative)
GmERAL IM‘ORMATION
\.subdivision Approved Date Lot size ilfllfv’Sq.Ft.
On Public Water Supply Watershed A,”’0 On Desigated Wetland M0”
SCS Soil Classification Public Sewer Scheduled M%’
KDate)
If residential,number of bedrooms f3 Flood zone 170
if non-residential,design criteria:
(sanitary Facilities,No.of mployees,Meals Served,Etc.)
Basement Fixtures Wk.)
l
Foundation Drains Ax s
Special Equipment A/m/c
exifv Mj’
Water Supply w '6 r ¢Type Well 'ADM/(c!
Veil Location Approved ~/Yield n/Satisfactory sample
DE e
Well Driller 's Name /Address
wATER SUPPLY womb—4
'I
\R
/
FORL SOUTH WINDSOR HEALTH DEPARTMENT APPLICATION NO.u -CEECK LISTfREVIEVOFPLANINSPECTION‘WOF SEWAGE DISPOSAL SYSTD!w‘DateO‘w‘uer Location N?Len/igiH /P»:/‘Rec 1d.
Design Percolation Rate /’&Mins./inch at hole(s)my
If residential,number of bedrooms 3 'If non-residential,estimated daily flow——
HOUSE SEWER (INVFJR‘I‘LEVELS)
I /
3epth at foundation wall Q-V
Depth at septic tank (g ’,J “f
Jot?“Maf4 (f.c/{igS PI'IC
Q5
TANK
(21?“/£’~/”‘K/‘%ileanout located ft.from and ft.from
Manufacturer Size 1;;6‘0 gals .Depth to'cleanout /D i//
LFACI-ENG SYSTEvi
Description I Vxzft/LZ‘kg;
Effective area “/{0 sq.ft.Required effective area V?f,sq.if.
tpacing between units 33 ft.l00j$reserve area provided
Bottom of leaching system 18 inches above maydmum water table /
Eottom of leaching system h feet above ledge rock /
Bottom of leaching system g.L inches below final grade.
Pumping required m V Curtain drain required if“?
'r,well on adjacent property >i‘7’vt‘t.To property line “r ft.
To house served 37316 ft.To dwelling adjacent property "Z ya?:‘t.
To nearest watercourse I ft.To nearest ground or surface water drain ‘_""ft.
Weviewe Inspec?ed\b
PLAN/INSTALLATION APPROVED &/‘DATE és M—9’3
INSPECTION FEE PAID
y j
:Dla“.prepared by .Title m Address
Site investigation 5‘k’lcz'xé'3 ,Investigated by (/9.@Qz‘yv/fx(DateT I
Bench mrk location Elevation
Serial distribution g ,a Level system h/a
SEPARATING DISTANCES
tell located f .
'/fto f§cm frc"wfj’AW wi£and ft.from
Distance sewage system to well on property '7)ft.‘ft.To water service
SOUTH HINDSOR HEALTH DEPARTMENT
(HousehoTd System)
PERMIT TO DISCHARGE
Approva]1's hereby given to Richard &Elva Kibbe to discharge to a
Owner
subsurface sewage disposaT system Tocated at 18 Long Hill Road
South Windsorinthetownof which wiT]receive
treated domestic sewage from a dweTTing containing -threxi bedrooms.
Construction Permit No.
InstaHation inspected by Robert Deptula TitTe Environmental Health Officer
Date of fina]inspection 6/21/93
Issued by:
Director o Hea t or Registered Sanitarian)
TWtie Environmental Health Officer
Issuance date 6/23i93
SPECIAL REQUIREMENTS OR RESTRICTIONS:
Excgnjous:Technical standards—sec 8 B -center to center 8'
sec 8 F —required 495 Square feet
installed 450 square feet
sec 2 Table 1 J
8 feet side 5/93jh
rear5n
PROVIDED:
1.Liquid discharge volume shaTT not exceed 125 gaTTOns
per bedroom per day.
2.The septic tank shaTT be inspected reguTarTy and c1eaned
not Tess frequentTy than every five years.