HomeMy WebLinkAboutSeptic New 270 Diane Drive TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No._
TO THE BUILDING DEPARTMENT: Date aL / 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: � p
' 1. Owner of Property �� t Address of Owner
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2. Location of Property I-d- P Lot. No.
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3. Type of Structure � Comme No. of Bedrooms�
(Dwelhn rcial Buudmg,Store,etc.)
4. Number of Families o� Occupy Premises_ <5 Al 'e_
5. Plumbing Fixtures: Water Closets .1 Urinals Lavatories____ Bathtubs—z—_
Showers Kitchen Sinks,_ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tan d Material of Septic Tan k / �� ,
7. Soil Conditions: Type of Soil Maximum ground water table��
(band,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-0�� Total
Other
Signatures . f l
( icensed 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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DtN PURPOSES ONLY,
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PROPERTY OF
NO. DIANE DRIVE SOUTH WINDSOR, CONN .
Being Lot No. 28 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 lines"
Scale 1" = 501I��
HAYDEN L. GRISWOLD C .E.
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