HomeMy WebLinkAbout1972-6-16 - 1254 Main Street - Septic As Built@nmn nf %nuth minham‘\25‘4
Department of Pollution Control Mam 8rSOUTHWINDSOR,CONNECTICUT
DRAIN LAYER’S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
Fee Paid $..................................By .................................................................................................................................................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 Persops 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 .............................................................................................................................................................................
If not served by public water supply:
Distance from Owner’s well ........................................................................
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 ...............................................................................................................................................................................
Classihcation of soil ....................................................................................................................................................................................................
Minimum square feet of edective seepage area required ...................................................................................................................................................
Leaching System:Number of trenches ................................................Length ...................................................Width ...................................................
Total ................................................Other .........................................................................................................................................................................
Plot Plan Attached................................................................
Layout Approved.....................................................................
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.7?Signature ................................................................
(Licensed Drain Layer)
Installation Completed,Inspected and Approved in accordance with State Public Health Code and Local Ordinances
...........................................................................................................................19 ..................By ................................................................................................................................................
Inspector
Pollution Problem abated Date ..............................................................................
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NOTES Scale =40‘in 1"approx.
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SOUTH WINDSOR POLLUTION CONTROL
LOCATION Main Street (Lot "A“)
‘(NJNER Faitella
TYPE OF WORK Septic Installatlon
DATE 66—20—72 PERMIT 7269 PIPELI"0.13-
INSTALLER Pippin (VW9—206z63)INSPECTOR ME llRAMni BY'ME
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TOWN OF SOUTH WINDSOR
TOWN HALL
SOUTH WINDSOR,CONN.06074
DEPARTMENT POLLUTION CONTROL
in accordance With the Town of South \Vindsor ordinances
and regulations.
Accepted and Approved
By Date
The Sanitary Sewer ........Septic System ..........
at ................................................
or lot #..............has been installed and completed