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 ................................................................................................................................................
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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