HomeMy WebLinkAbout1976-4-28 - 1430 Main Street - Septic As BuiltEnmn nf $nmh minhanr
Department of Pollution Control
SOUTH WINDSOR,CONNECTICUT
DRAIN LAYER’S PgRMIT
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:
Installation Completed,Inspected and Approved in accordance with State Public Health Code and Local Ordinances
...................................................................................................................................19 ..................By ................................................................................................................................................
Pollution Problem abated Date ..........................................................................................................................................................................................................................
Inspector
1.Owner of Property ........2 .........................................................................................Address of Owner
2.Location of Property .............................................................................................................................................................................................LOt No.
3 Type of Structure ........................W..E .........{U .................................................................................................................................................................................................................
(Dwelling,Commercial Building,Store,etc.)
Premises4.
5.
Number of Families or Persons to Occupy ................................................................................................................................................................
Number of Bedrooms ................................................
6.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 ..........................................................2%.
9.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
11.Percolation Tests:Time for 1"drop in soil test ................................'
Classihcation of soil ....................................................................................................................................................................................................
l2.Minimum square feet of effective seepage area required
13.Leaching System:Number of trenches ................................................Length ...................................................Width
Total ................................................Other .........................................................................................................................................................................
l4.Plot Plan Attached................................................................
l5.Layout Approved.....................................................................
l6.This permit expires ..................................................................................................................
PNNEn Signature ..................................................................................................................................................................................
(Licensed Drain Layer)
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SOUTH WINDSOR POLLUTION CONIROL
LOCATION 1Lmo Main
OWNER McKenna
TYPE OF WORK S ''o
DATE PERMIT 76—06 PIPEINSTALLERHWL(S.I.)
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TOWN OF SOUTH WINDSOR
TOWN HALL
SOUTH WINDSOR,CONN.06074
DEPARTMENT POLLUTION CONTROL
or lot #...............has been installed and completed
in accordance with the Town of South Windsor ordinances
and regulations.
Accepted and Approved
By Date