HomeMy WebLinkAboutSeptic New 140 Diane 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, 19
A permit is requested for repair or construction of an individual sewage disposal system concerning whic the
following information is submitted: n<1 /Late
1. Owner of Property Address of Owner
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2. Location of Property'y `` Lot. No.
3. Type of Structure l) P 1 ! Vl� No. of Bedrooms_
(Dw ling,Commercial Building,Store,etc.)
4. Number of Families or-Ptreefie.-to Occupy Premises_ e)W
5. Plumbing Fixtures: Water Closets ! Urinals Lavatories_ Bathtubs_
Showers Kitchen Sinks_ Laundry Tubs Garbage Grinder Other ,[�
6. Liquid Capacity of Septic Tank f7 a Material of Septic Tank �`� G p—
7. Soil Conditions: Type of Soi Maximum ground water table A ui
(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
12. Leaching System: Number of trenches Length / Width Total
Other
Signature
(LAcensed Installer)
(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. DIANE DRIVE SOUTH WINDSOR , CONN .
Being Lot No. 15 on map entitled "Map of HIGH FARMS Kelly Road
South Windsor, Conn. Property of Edward, Joseph & William Kelly
Subdividers Robert Stone' & Jack 'Goldberg Scale 1" - 50 ' April 6,
1959 Hayden L. Griswold C .E. Sheet 2 of 2 Rev. Jan . 8, 1963 to
show change of building limes ."
Scale 1 " 50 ' /y�;� /✓ /� y
HAYDEN L. GRISWOLD C.E.