HomeMy WebLinkAboutSeptic New 121 Edgewood Drive If ,•
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_ Z/ — G/ 19�
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: Q
1. Owner of Property,D �Y :C_,, Address o`f''Owner O p
2. Location of Property / �,� '�`�' - CIJ �D� Lot. o.
3. Type of Structure CL No. of Bedrooms 3
(Dwelling,yommercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals d Lavatories_r-_2— _ Bathtubs_
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank
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 Classification of soil C1Y J
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length./ Widt Total
Other
Signature -=' , r
(licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
600 d4
71,
all a\11
, v1
10
J „6 y
r
r
PROPERTY OF
t
SURN�
!uuunsi>t�N EDGEWOOD DRIVE SOLITti WINDSOR, CONK .
Being Lot No. 358 on map entitled "Subdivision of Section VII
of PLEASANT VALLEY ESTATES South Windsor, Conn. Scale 1 " _ 60'0"
Ju I y .23, 963 ._by Pr-i m_us- NPe-I t-i-___Cgr_s_,., -- - - _- -- - - -- — -- -- - - - - - ---
Sca l e 1 " 60'
HAYDEN L. UZISWOLD C. E.