HomeMy WebLinkAbout1977-6-17 - 179 Newberry Road - Septic Application and Planfor
information is submitted'f...’
Owner of Property ........\................................................................."...........Address of Owner ...................................................................................................
Location of Property ............./’/7 .....//”’?"C!.......[.........................................................................................Lot No 7TypeofStructure.............................................................................................................................................................................................................................................................
Dvuellmg,Commercial Building,Store etc)
Number of Families or Persoprfs to Occupy Premises .....................€..........................................................................................................................................
Number of Bedrooms .................Jii .......................
Average Daily Flow ..................................................
anufacturer nd
Liquld
$011 Condltlons
CapaCIty
Type
of Septic
of Scll
Tank ...........................................................4....i.........C.(.‘.Material
.2 l r of
.
Se tic
(’(t
Tank..(”x ..........................................................................................
(Sand,Gravel,Clay,etc.)
Maximum ground water table .................................................................................................................................................................7 ..........
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 l”drop in soil test ..............................................................................................................................................................................
Classidcation of soil ....................................................................................................................................................................................................
Minimum square feet of eEective seepage area required ...................................................................................................................................................
Leaching System Number of trenches ................................................Length ...................................................Width ...................................................
14.
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16
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Signature .I.&
Licensed Dram L er)
Enum 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
/O '6/0?
/’V/
Penmt N
Date ..
Pursuant to written application,permission is hereby granted to the Licensed Drain Layer named herein
repair .........or construction of an individual sewage disposal system conceming which the following
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Total ...........................................Other .........................................................................................................................................................................
Plot Plan Attached (..m.....................................
Layout Approved
Thls permlt expires ..................................................................................................................
(fxfxf coRMa)
Installation Completed Inspected and Approved 1n accordance w1th State Public Health Code and Local Ordinances
,i I
Inspector
..........................................................................................................................19 ..................By ,
Pollution Problem abated Date K /7 7 7
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