HomeMy WebLinkAboutSeptic New 20 Gordon 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 tl 'f _19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the.
following information is supinitted: f,_
1. Owner of Property ' � c M Address of Owner
2. Location of Prope��' f � Lot. Now
3. Type of Structure
No. of Bedrooms
welling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Oc upy Premises
1
5. Plumbing Fixtures: Water Closets Urin Lavatories 6-*Z— Bathtubs f'
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank C`' 'Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand;-Gravel,Clay,etc.)
r
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 of/embankment
10. Percolation Tests: Time for 1" drop in soil test a Classification of soil
11. Minimum square feet of effective seepage area required — 7g
12. Leaching System: Number of trenches 1-F Length—Z!K ' _ Width � Total
Other / �J
Signature_
(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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+ FOR BUILDING PURPOSES ONLY
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PROPERTY OF '
NO . Sl1SAN DRIVE SOUTH WINDSOR, CONN.
Being Lot No. 12 on map entitled "Property of Rolling Park
Homes, Inc. South Windsor, Conn. Scale 1 " = 60' January 10,
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105711
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Scale ( " = 40' 17
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HAYDEN L . GRISWOLD C.E. E
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