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HomeMy WebLinkAbout1972-6-23 - 1031 Main Street - Septic Application@nwn nf §mtth minhanr Department of Pollution Control SOUTH WINDSOR,CONNECTICUT DRAI&LAYER’S PERMIT Application for Permit to Install o epair Individual Sewage Disposal System Fee Paid $....................................By .......................................................v ........................................................................................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 concerning which the following information is submitted: Owner of Property ..................................................................................................Address of Owner ................................................................................................... Location of Property .............................................................................................................................................................................................Lot No............................... Type of Structure ............................................................................................................................................................................................................................................................... (Dwelling,Commercial Building,Store,etc.) Number of Families or Persons to Occupy Premises ..........................i .................................................................................................................................. Number of Bedrooms ................................................ Average Daily Flow ................................................... Manufacturer and Liquid Capacity of Septic Tank .........................................................Material of Septic Tank ......................................................................................... Soil Conditions:Type of Soil ............................................................................................................................................................................................................................ O3OI$ Maxrmum ground water table .............................................................................................................................................................................. If not served Distance by frompublic Owner’s water supply well .......................................................................ANNEp From adjacent wells ............................................................................................. 10.Distance to nearest water course,drainage ditch,storm drain or embankment .......................................................................................ll.Percolation Tests:Time for 1"drop in soil test .............................................................................................................................................................................. Classincation of soil .................................................................................................................................................................................................... Minlmum square feet of eHective seepage area requlred ...................................................................................................................................................Leaching System Number of trenches .................................-...............Length ...................................Width ...................................................Total ................................................Other ......................................................................................................................................................................... Plot Plan Attached................................................................ Layout Approved.................................................................... This permit expires ..................................................... l2. l3. l4. 15. 16. (Licensed Drain Layer) Installation Completed,Inspected and Approved in accordance with State Public Health Code and Local Ordinances Pollution Problem abated Date .............................'............................................Z T .............................................................................................................................................. Inspector ..........................................................................................................................19 ..................By ................................................................................................................................................ l i ,‘ Eewé r iI 1 §m‘i}CI Exmrmg VEHK B l Isi NOTES:Scale =#O'in 1"approx. S T D f B A .2 73o? 66.4 72.2Point”A“is the north side of the garage door SOUTH WINDSOR POLLUTION CONI‘ROL LOCATION 1031 Main Street OWNER K urnham TYPE OF WORK Septic Repair DATE 06—26—72 PERMIT 62—96 PIPELw 0.13. INSTALLER Adam (w9-2o6559) INSPECTOR ME DRAWN BY ME