HomeMy WebLinkAbout1972-6-14 - 1544 Main Street - Septic As Built@nmn nf $111111;minhanr
Department of Pollution Control
SOUTH WINDSOR,CONNECTICUT
DRAIN LAYER’S PERMIT
Application for Permit to Install or Repair Individual Sewage Disposal System
Fee Paid $...................................By .................................................................................................................................................Permit No.............................................................
Date ...........................................................................
Pursuant to written application,permission is hereby granted to the Licensed Drain Layer named hereint
for repair ......or construction .........of an individual sewage disposal system concerning which the following
information is submitted:
1.Owner of Property ..................................................................................................Address of Owner .........'."....‘.....................................................................................
2.Location of Property .............................................................................................................................................................................................Lot NO...............................
3 Type of Structure ...............................................................................................................................................................................................................................................................
(Dwelling,Commercial Building,Store,etc.)
Number of Families or Persons to Occupy Premises ..........................i.......i "I ..................................................................................................
N%ber of Bedrooms ................................................
6.Average Daily Flow ...................................................
01$
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:
Distancefrom
From ad]acent
OWner’s
wells ....................................
well ......
z ........................................................
.€AN NEQ
10.Distance to nearest water COurse,dralnage ditch,storm drain or embankment .......................................................................................
ll.Percolation Tests:Time for l”drop in soil test .....................................................................................;:......T?.................................................................................
Classincation of soil ....................................................................................................................................................................................................
l2.Minimum square feet of eHectlve seepage area requlred .........................T .........................................................................................................................
13.Leaching System Number of trenches ................................................Length ...................................................Width ...................................................
Total .............I ..................................Other ...........................................................................................................l.,..........................................................
14.Plgt Plan Attached................................................................
l5.Layout Approved....................................................................
l6.This permit expires ............................................................T.....................................................
Signature ....................................................................................................t ..............................................................................
(Licensed Drain Layer)
Installation Completed,Inspected and Approved in accordance with State Public Health Code gd Local Ord'giances
..................................................................................................................................19 ..................By ..........V .....................................................................................................................................
Pollution Problem abated Date ..........................................................................................................................................................................................................................
Inspector
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NOTES:Scale =None.LST 2&A 13.0 19.0
B 37-0 #52
SOUTH WINDSOR POLLUTION CONTROL
LOCATION 1554 Main Street
OWNER Geor e HackTYPEOFWORKSepticWRepair
DATE 06—20—72 PERMIT 72~38 PIPE4"O-B.
INSTALLER adam avg—206559)
INSPECTOR ME DRAWN BY ME
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