HomeMy WebLinkAboutSeptic New 19 Charing Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
.Application for Permit to Install or Repair Individual Sewage Disposal System
Applicati No.
TO THE BUILDING DEPARTMENT: Date, G.r_ � 19—
A permit is requested for repair or construction of an individual sewage disposal system concernin which the
following information is=ted,
r s ,
1. Owner of Property Address of Owner, Aid
2. Location of Property 9 Lot. No.
3. Type of Structure No. of Bedrooms
elling,Commercial Building,St etc.)
4. Number of Families or Persons to Occupy Premises_ Cyr-
5. Plumbing Fixtures: Water Closets Urinals La$atories Bathtubs
Showers Kitchen Sinks__ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 1elb rf Material of Septic Tank_ i�a .
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 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,�� �P —Classification of soil
11. Minimum square feet of effective seepage area requireddo�f—
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12. Leaching System: Number of trenches Length Width 3 Total
Other 5 "2—
Signature 7�6'
(Licensed Installer(T
(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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�;t,;et;�,•�;�:�ti PROPERTY OF
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4` N0. CHARING ROAD SOUTH WINDSOR, CONK. 2'
Sk ng Lot No. 14 on map entitled "Whilshire Woods Section II
Subdivision Map Prepared for Ross Hahn South Windsor, Conn. John
t J. Mozzochi Associates Scale 1 " = 401 10-25-60" {
Scale 1" -- 40 - - _ _ ,, <
' HAYDFN L. GRISWOLD C.L.
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