HomeMy WebLinkAboutSeptic New 128 Birch Hill Drive t
TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Applic on No. �u
TO THE BUILDING DEPARTMENT: Date 19��
A permit is requested for repair or construction of an individual sewag ispo al system concerning which the
following information is submitted: CO/SWIN
1. Owner of Property r Address of Owner_
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2. Location of Proper ya V,;,4 zt�w-I V Lot. No. c,2—
3. Type of Structure welling,Commercial B ' ng,Store,etc.) No. of Bedrooms
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinde Other
6. Liquid Capacity of Septic Tank Material of Septic Tank �6
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,Clay,etc.) ,
8. If not served by public water supply: Distance from Owner's we from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test IJ Classification of soil
11. Minimum square feet of effective seepage area required a 5,4P 1/ Joi
12. Leaching System: Number of trenches_ Length WidthJ�/ 1/ Total 7J�
Other
Signature
(Licensed starer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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PROPERTY OF
NO. BIRCH HILL DRIVE SOUTH WINDSOR, CONN.
Being Lot No. 21 on map entitled "BIRCH HILL ESTATES Foster Street
South Windsor, Conn . Property of U & R Housing Corp. Scale 1 " 100 '
Date : Jan . 21 , 1963 Hayden L. Griswold C .E."
Scale 1" = 501
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} HAYDEN L. GRISWOLD C .E. °