HomeMy WebLinkAbout1972-9-25 - 1024 Main Street - Septic Application@nnm nf §>mtth minham‘
Department of Pollution Control
SOUTH WINDSOR,CONNECTICUT
DRAIN LAYER’S PERMIT
Application for Permit to Install or Repair ndividual Sewage Disposal System
Fee Paid $....................................By Check No.2453 Permit No.....................................
Date ...........................................................................
Pursuant to written application,permission is hereby granted to the Licensed Drain Layer named herein
for repair ........or construction .........of an individual sewage disposal system conceming which the following
information is submitted:
Owner of Property ..................................................................................................Address of Owner .........................................................................................
Location of Property .............................................................................................................................................................................................Lot No...............................
Type of Structure ................................................................................................................................................................................................................................................................
Dwellmg,Commerc1al Building,Store etc)
Number of Famllles or Persons to Occupy Premises ......................................................................................................................................
Number of Bedrooms ................................................
Average Daily Flow ...................................................
Manufacturer and
Liquid Capacity of Septic Tank .........................................................Material of Septic Tank ..........................................................................................
Soil Conditions:Type of Soil ............................................................................................................................................................................................................................
(Sand,Gravel,Clay,etc.)
Maximum ground water table ..............................................................................................................................................................................
9.If not served by public water supply:
Distance from Owner’s well ........................................................................
ODOI§)
From adJacent wells .............................................................................................staumew10.Distance to nearest water course drainage dltch storm dram or embankment ..................‘.............................................
l4.Plot Plan Attached................................................................Dry wells by Richards of Torrlngton,Conn.
15.Layout Approved............X e$..............................................
16.This permit expires ..........l.........................................................................................................
Signature ..................................................................................................................................................................................
(Licensed Drain Layer)
Installation Completed,Inspected and Approved in accordance with State Public Health Code and Local Ordinances
....................................................................................................................................19 ..................By ........................................................................................................................................
Pollution Problem abated Date ........26....S.e.p.t.emb.ext.,....19.72....ards,Jr.
Inspector/..w
ll.Percolation Tests Time for 1"drop 1n 5011 test
Classmcation of soil
l2.Minimum square feet of eEective seepage area requiredl3.Leaching System Number of tren-ches ...........................................KTotalOther\Length ...................................................Width
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NOTES
Not drawn to scale.
#1 #2A75K07B5746
SOUTH WINDSOR POLLUTION CONrROL
LOCATION 102+Main Street
OWNER Walter M.BurnhamTYPEOFWORKSet'c Re irDATE09—26—72 PERMH 72—82 PIPE 1+"0.3.INSTALLER Adam (W9-206559)INSPECTOR ME DRAWN BY ME