HomeMy WebLinkAboutSeptic New 23 Broadleaf Drive s TOWN` OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. /
TO THE BUILDING DEPARTMENT: Date. / .�2 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: ia rA
1. Owner of Property 'i Ad of O vner /lJ
2. Location of Property:�a,&e.,& Lot. No.
3. Type of Structure II ) N No. of Bedrooms
(Dwelling,CbMmerclal Buil6rig,Store, .)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories_ Bathtubs_
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank Z C r-e
C1 l
7. Soil Conditions: Type of Soil 11'?v-e I Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well 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 Classification of soil
11. Minimum square feet of effective seepage area required ,:v,G rj
12. Leaching System: Number of trenches Length ®- _ Width_ r� Total -�~aG
Other
Signature—.-
(Licensed Installe
(Sketch showing all minimum distances and other details require ow)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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C4 PROPERTY OF
., SURVEY ,
NO. 13ROAD LEAF DRIVE SOUTH WINDSOR, CONN.
Being Lot No. 28 on map entitled "Map of OAK RIDGE ESTATES
a
Foster St.r South Windsor, Conn. Scale : I" 40' Sept. 5, 1965
+ Hayden L. Griswold C.E. Sheet I"
Scale-I" _ 0'
HAYDEN L. GRISWOLD C.E.