HomeMy WebLinkAboutSeptic New 78 Glenwood Road 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_ y( — y 3 19_f
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: p4 pdI!1!!! �
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1. Owner of Property Address of Owner
2. Location of Property a Lot. No. 4 /
3. Type of Structure No. of Bedrooms 3
(Dwelling,Commercial Building,Store,,etc.)
4. Number of Families or Persons to Occupy Premises_ ULr—e
5. Plumbing Fixtures: Water Closets IV— Urinals Lavatories 2 Bathtubs l
Showers Kitchen Sinks Laundry Tubs Garbage Grinder n/ Other
6. Liquid Capacity of Septic Tank 0 O D ar, Material of Septic Tank L;✓D"✓ �
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
i10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11- Minimum square feet of effective seepage area required d A
12. Leaching System: Number of trenches Length Width Total
Other
Signatur
(Licensed 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.78 GLENWOOD ROAD SOUTH WINPSOR , CONN
Being Lot No. 61 on map entitled "Plan of bRCHARP HEIGHTS Avery
Street - South Windsor, Connecticut Scale : 1 " - 40' May 20, 1965
Hayden L . Griswold C . E . Sheet I of 3"
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Scale l „ _ 40. J';'� %�. w--
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GR I SWO LD ENGINEERING INC.
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