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Home My WebLink About1995-11-14 - 240 Newberry Road - Septic Application and PlanTOWN OF SOUTH WINDSOR HEALTH DEPARTMENT Application for permit to instaH a new/repair subsurface sewage disposal system.To the Health Department, Town of South Windsor FeePaId Date i/T’ /l‘/m @3’Permit Number As a subsurface sewage disposal sy/stem instaiier Ticensed in the State of Connecticut,i /7¢;Mai eff?M//$—Si‘®49Aé /2v&77~§0/.?/00a 4f 7 Address TeiephoneNumber Li ns Number hageby apply for a permit to construcw>a subsurface sewage disposal stem loccéeed at y?*7?)/JZ10V;7<‘24!AuQ and owned by/?f“5/0/J Street Address Lot Number Name WK Address Information to be supplied by Applicant: Type of dwelling £55’ Numberofbedrooms Size oflot /"’6 7L3 Number of fixtures above basement Tubs,Sinks,Toilets,Etc. Number of fixtures in basement,ifany Type of watersupply Pa g L g’(i F;or Residential‘Commercial,Etc. .if non-residential,estimated daily flow Pumped orgravity flow, Public-Private .If private,type of well Information to be supplied by Health Department: Soil type atvarious levels Percolation rate Size of septic tank .Square feet of effective leaching area required Type of system Trenches,Drywells,Etc. Number of dry wells,trenches,etc..Distance between individual leaching units.Distance from well on same property on adjoining property Curtain drain required Yes,No Height of system above ground water ledge ,maximum ground water ,impervious soil layer If automatic closing is required,description I A PLOT PLAN INDICATING LOCATION OF PROPOSED STRUCTURE,WATER SUPPLY,SEPTIC SYSTEM,EM- BANKMENTS,WATERCOURSES,PROPERTY LINES AND ALSO INDICATING EXISTING AND PROPOSED FINISHED GRADES MUST BE SUBMITTED BEFORE THIS PERMIT CAN BE ISSUED. THIS PERMIT IS NOT TRANSFERRABLE FROM PERSON TO PERSON OR FROM PLACE TO PLACE. NO PART OF THE SYSTEM SHALL BE BACKFILLED UNTIL IT HAS BEEN INSPECTED AND APPROVED BY THE SANITARIAN. SPECIFICATION AND REQUIREMENTS AS STATED IN THIS PERMIT MUST BE MET AND ANY CHANGES MUST BE APPROVED BY THE TOWN SANITARIAN BEFORE FINAL APPROVAL WILL BE GIVEN. THIS PERMIT SHALL NOT BE CONSTRUED AS PERMISSION TO CREATE A NUISANCE CONDITION NOR IS THIS SYSTEM GUARANTEED BY THE HEALTH DEPARTMENT. y 3 Permit Received by K fwd/M W Date ///¢ Signéure of Applica &License Number For Office Use Only DatePermitissuedby System installed by DateFinalInspectionApproval v TOWN OF souw WINDSOR HEALTH DEPARTMENT Application for permit to install a new/repair subsurface sewage disposal system.To the Health Department, Street,Address.Lot Number Name Address Information to be supplied by Applicant: Type of dwelling .If non-residential,estimated daiiy flow Numberof bedrooms Size of lot Number of fixtures above basement Number of fixtures in basement,ifany Type of watersupply lf private,type of well Residentiai,Commercial,Etc. Tubs,Sinks,Toilets,Etc, Pumped or gravity flow, Public»Private Information to be supplied by Health Department: Soil type at various levels —I iPercolationrate.Square feet of effective leaching area required_Size of septic tank Type of system Trenches,Drywells,Etc, Number of dry wells,trenches,etc..Distance between individual leaching units.Distance from well on same property on adjoining property Curtaindrainrequired Yes,No Height of system above ground water ,maximum ground water ledge ,impervious soil layer If automatic closing is required,description I A PLOT PLAN INDICATING LOCATION OF PROPOSED STRUCTURE,WATER SUPPLY,SEPTIC SYSTEM,EM- BANKMENTS,WATERCOURSES,PROPERTY LINES AND ALSO INDICATING EXISTING AND PROPOSED FINISHED GRADES MUST BE SUBMITTED BEFORE THIS PERMIT CAN BE ISSUED. THIS PERMIT IS NOT TRANSFERRABLE FROM PERSON TO PERSON OR FROM PLACE TO PLACE. NO PART OF THE SYSTEM SHALL BE BACKFILLED UNTIL IT HAS BEEN INSPECTED AND APPROVED BY THE SANITARIAN. SPECIFICATION AND REQUIREME-NTS AS STATED IN THIS PERMIT MUST BE MET AND ANY CHANGES MUST BE APPROVED BY THE TOWN SANITARIAN BEFORE FINAL APPROVAL WILL BE GIVEN. THIS PERMIT SHALL NOT BE CONSTRUED AS PERMISSION TO CREATE A NUISANCE CONDITION NOR IS THIS SYSTEM GUARANTEED BY THE HEALTH DEPARTMENT. Permit Received by ’Date Signature of Applicant &License Number ForOffice Use Only DatePermitissuedby System installed by DateFinalInspectionApproval Town of South Windsor. Fee Paid 'LJsii Date Permit Number As a subsurface sewage disposal system instalier Iicensed in the State of Connecticut,i LicenseName,Address,TetephoneNumber, hereby appiy for a permit to construct/repair a subsurface sewage disposai system Iocated at c?~V andowned by TOWN OF SOUTH WINDSOR HEALTH DEPARTMENT Application for permit to install a new/repair subsurface sewage disposal system.To the Health Department, Town of South Windsor. Date Permit NumberFeePaid As a subsurface sewage disposal system installer licensed in the State of Connecticut,i Name,Address,Telephone Number,License Number hereby apply for a permit to construct/repair a subsurface sewage disposal system located at andownedby Street,Address,Lot Number Name Address Information to be supplied by Applicant: Type of dwelling .lf non-residential,estimated daily flow Residential,Commercial,Etc. Public-Private Information to be supplied by Health Department: Soil type at various levels Percolation rate .Square feet of effective leaching area required Size of septic tank Type of system Trenches,Drywells,Etc, Number of dry wells,trenches,etc.Distance between individual leaching units.Distance from well on same property on adjoining property Curtain drain required Yes,No Height of system above ground water ledge ,maximum ground water ,impervious soil layer lf automatic closing is required,description -TEs?—'A PLOT PLAN INDICATING LOCATION OF PROPOSED STRUCTURE,WATER SUPPLY,SEPTIC SYSTEM,EM- BANKMENTS,WATERCOURSES,PROPERTY LINES AND ALSO INDICATING EXISTING AND PROPOSED FINISHED GRADES MUST BE SUBMITTED BEFORE THIS PERMIT CAN BE ISSUED. THIS PERMIT IS NOT TRANSFERRABLE FROM PERSON TO PERSON OR FROM PLACE TO PLAC . NO PART OF THE SYSTEM SHALL BE BACKFILLED UNTIL IT HAS BEEN INSPECTED AND APPROVED BY THE SANITARIAN. SPECIFICATION AND REQUIREMENTS AS STATED IN THIS PERMIT MUST BE MET AND ANY CHANGES MUST BE APPROVED BY THE TOWN SANITARIAN BEFORE FINAL APPROVAL WILL BE GIVEN. THIS PERMIT SHALL NOT BE CONSTRUED AS PERMISSION TO CREATE A NUISANCE CONDITION NOR IS THIS SYSTEM GUARANTEED BY THE HEALTH DEPARTMENT. Permit Received by Date Signature of Applicant &License Number ,For Office Use Only Permit issued by Date System installed by Final Inspection Approval git Date Number of bedrooms Size of lot Number of fixtures above basement -'-Tubs,Sinks,Toilets,Etc. Number of fixtures in ibasement,if any ,--Pumped or gravity flow, Type of watersupply .lf private,type ofwell “#6 N»: f.W9j D w ‘55 cm i r O9L/b3t r e a,- L/L/‘’f Vii (Jr? // f ,vw ~awwwiéfky [70d ’ r?\§\\ 3V ‘*M’g“1i Wt.w b r,v W1 Wk;;.,,f‘.’,hf a :‘x-W‘ , Ed. NOTES ,M g3 ..Czar SOUTH WINDSOR HEALTH pEPARTMENT LOCATION OWNER Suwag V“V‘x!rig’ TYPE OF WORK 5 V342”5f“PIPE INSTALLER L,_g we;A? INSPECI‘OR 4143 V;DRAWN BY g!)J; "AnuqVt\Ana;xJUUlKl IEVES!IGATICH ?OR SEHAGE1EHEEKEM¢.Snf§E¥I cum 'a'5 LSCAEION &%5 /U§LJ &r6%/JQd mourn!m:(Recu'd tn tun){c—ns‘h’SOIL MOISTURE: zDttei (E132,mo,lav,etc IA3ULATIOH O?TEST EESUtTS Depth.Prue-k mum Pas-minim RueHalomum(Inrh-s )g Era.2 (yin./I:¢h) H N F‘u’ FBFMATION m:(Reccrd m pits){047.45 ’Grand water Mia:3“ MWTION OP OBSEVA‘FION FITS Grannd Soil Degth Lad g a At Ugtet At mt‘m Kggn cLxF\TEST READINGS EGLB #1 m #2 acza #3 m2 aim Tia.Reading Tine Reading Time Regain;Time Heudim é £7 3?“?e‘[L L/f 7y é,’1 (i3 yz e 2f 75"/y ‘Ia-investiarcéou :qr ;,n€e msp‘”3 mt.mam #2 scum wINDsoa HEALTHDEPARTMENT 5mm COEDITIO$ Hiram sail (30 -60 msJinah)Shsuw ledst (less tun 7 rt.) Undarlying tight soil (less than ‘4.rt)Other COMUSIOK /Suiubla £0:sew dispcm unsuiublc :o:”was:dispasal Additiaul investiaucn aqua-ed Retest dung;wet seuon Wat's gm required , system dam Large:than 2,000 g.p.d.“we:suppu aux-shed ash mud.gate:(less than 1%rt.)Possible 3mm wate:mm wsurccurse,man er pand Pauible seuoaal tlooding mated math are:S1ope over 152* DEIGN REGRETDATIORS Izvestiated by ywg‘r Titlc Csuina/witnessed by 1:1. Cements: Benchmrk lxaticn Elevatian