HomeMy WebLinkAboutSeptic New 115 Gray Road i
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_3// 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is s mitted: J 14A trly 11IXTo
1. Owner of Property Address of Owner ed
2. Location of Property �d,2e,,Vp- N!"5J Lot. No. _
1, 3. Type of Structure (n ing,Commercial Build tore,etc.) No. of Bedroom
s
4. Number of Families or Persons to Occupy/Premises_-
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p{ _ s_
• 5. Plumbing Fixtures: Water Closets Urinals V Lavatories Bathtub
Showers_ Kitchen Sinks_ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tan & V Material of Septic Tank ...G►"'!'Z44--, .. ` `1-
7. Soil Conditions: Type of Soil - f(.0 Maximum ground water table
and, ravel,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 /
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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PROPERTY OF
NO. GRAY ROAD SOUTH W I NDSOR, "CONN
Being Lot No. 24 on map entitled "Plan of ORCHARD HEIGHTS
Avery Street - South Windsor, Connecticut Scale : 1 — 40' May
20, 1965 Hayden L. Griswold C.E . Sheet 3 of• 3"
Sca f e 1.. „ 40,
GRISWOLD ENGINEERING INC.