HomeMy WebLinkAbout1979-10-26 - 100 Main Street - Septic ApplicationTOWN OF SOUTH WINDSOR
HEALTH DEPARTMENT
Application for permit to install arepair subsurface sewage disposal system.To the Health Department,
Town of South Windsor.
Fee Paid 12K ~We ,v/Date Permit Number ’(s _1;
Street,Address,/l"LoiNurnber
‘
Name
Address
Type
Information
of dwelling
to be suppluejpby Applicant
FieSIdential,Commermal,Etc.""'7\.§Size of IotNumberofbedrooms
Number of fixtures above basement
.lf non-residentiai,estimated daily flow
Tubs,Sinks,Toilets,Etc.
Number of fixtures in basement,ifany
Type of water supply Wilt/K
Pumped or gravity flow,
Public-Private
.if private,type of well
Information to be supplied by Health Department:
Soil type at various levels smit/
Percolation rate .fmm /,‘m l,.Square feet of effective leaching area required ‘57 f 775
Size of septic tank 4 Type of system 7 )“E :V‘é/{mJ
Trenches,Drywells,Etc.
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.
Permit Received by W Date {V}9":L 3?j/jx’I/k
[Q ,7 {l/fS’gnatuPEKApplicant &License Number f
For Office Use Only
Permit issued by II;[)1J //{i J K Date n“j L/(2
System installed by i/w w y /m 1 K“
Final Inspection Approval y 'U1 [X’A/Date ,c‘‘)1 7 r,
%
As a’subsurface sewage disposai system instailer Iicensed In the State of Connecticut l
”‘7“itJ /far/”w”a vW/wc/w’gig :s .iL/Xhx‘é/Vs/a7[/WK§I)7///
Name Address TelephoneNumber LicenseNumber
hereby appiy for a ogmit to construct/repair a subsurface sewage dJ§posal system located at
Number of dry wells,trenches,etc.’Z/Distance between individual leaching
units.Distance from well on same property ’T’on adjoining property 1'
Curtain drain required 17 u
Yes,No
Height of system above ground water ,maximum ground water /.X
ledge f
,impervious soil layer w—
If automatic closing is required,description 1/L;
NOTES SOUTH WINDSOR POLLUTION CONI‘ROL
LOCATION;g.+2
‘OWNERTYPE OF WORK
DATE /0-g é.».:-PERMIT ':4»:vé PIPE
INSTALLER ._‘INSPECTOR x DRAWN BY
Information to be supplied by Applicant:éyyitféXL
Name and Address of Applicant [SQMLg’p Wtorq'a.‘Jr?Jaxémh A&J-J
Location of Property 2Q?0 £”aHh.‘f?Address;Street,Lot Number
APPLICATION FOR SITE INVESTIGATION AND PERCOIATION TEST
m¢mulitj4eo
Name'and Address of Owner &1%~m:
Site of Lot Type of Water Supply
Signature of Applicant Date
Information to be supplied by Health Department:
Description of Property wJ/
é»~23e’>9.
Soil,Conditions:’
Observation Pit #1
farme—a;W1
Observation Pit #2
’l
c2 to 3a ‘
ll igéto‘7
t0
to CV‘"xtej’
to M)
he fi/fy iemc/
to
t0to
to to
Log of ?ercolation Tests:Test Wa ter
gole #Depth Time level
1i
Observation Pit #3.{gr We)
to
to
to
to
to
Rate
Min./In.
Time
Interval
wQ]$%I 7%}/
al 3i?57Mh«
o2”?35’‘f/“fh j ”u YM%Z
t
Design Rate Design Rate
Remarks é'v.
\or
F
Tests conducted by Date
Approved for septic system —yes L/’/'Iu)
DateSignatureofSanitarianf01rod.
I
’
(5f£4
(-3—(3»99
Q45“,)6}
M‘a/
(;~&bloo£2£:yi/
I/'
Test
Hole #Depth Time Water
Level TimeInterval Drop RateMin./In.
(’00 /Mui"\2(7—
gy 44/[W//_
M 147/(:1 '
‘1 fwKph yd \
[wcu‘(«’L
//'7
#[4A/
,#—Z
0 \36 //
My]FatI f [/74 (4&7 I
34"—7 ”75pm
'j,/)/Y_StL-c
é w a¥éVL
Mf’y—lHzg;a V74?)#257 L
fgr%gili/ft/Vo fa“J)
5
If;I 9.!"
W52 ’j:
n 6?if,D’—
2"Lv-L ~j§“”f ’.5/Q /."'I 5"
Ii juxw.,€)Vi truqékr
;:pcdmbarg x Hus;o
‘f 94 70 .2J /
314 4‘
”7?q*g VQOQ)é:i
KH0us&
:1“.Fm.RE.@AQn£L£¢xoaésxrm “w.
I
z
LL
z
Q
19
tD `.)a - �--4' t--
i
• I
Q
7
i
i
6`
!
' S•7Z1
�J1
19
i W ;-C p
,1
1
1
t
•�Y
A.:�a
s�
W _3 �.
I � Z �
LN
r�
Q
j
1
i
I
I
1
!�
f
C
1
-- — -- - 5B. Z-7.
r
I '
cY �
M
LA
Z
�J
�
Q
�
�
v
Q
LT
v J
�
z
%j
z
} ;}
Wn
n
J
O
z
�
V
\_
=
J
Q
O
G
Q
O
W
r-
�
v
F
Oa
�
LLA
O
W
Z
�►i d �
�
l9
�
LLJ
c
2
A/
W
00
�
%.M cc
Q
�
O
v
J
W
...I
ON
>
N V1
0
cc
936.
Z
J 1
G�'
O
2
�
J
�
V
J
d
w
z
2
1
vi
�
v�p
0
lJ
41'
1
'_
a
IV
-