HomeMy WebLinkAboutSeptic New 55 Greenfield Drive 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_ 2 — 19 So
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submi ted: �}
1. Owner of Property Addrr ss of Owner -tt7t 11��
2. Location of Property Lot. No.
3. Type of Structure —No. of Bedrooms
(Dwelling,Commercial-Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ c w-y N-Q-
5. Plumbing Fixtures: Water Closets � Urinals Lavatories — Bathtubs
Showers / Kitchen Sinks_ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tan d o a Material of Septic Tank e:r'n ili A az L
7. Soil Conditions: Type of Soil Maximum ground water table
and,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 l
12. Leaching System: Number of trenches 4- Length L&C � Width 2•AFT Tota1412.i U 97
Other
Si natur
o (Licensed Installer
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
„ ..,., .. � .,::.5 �J'� 3 � .: 44'i� ..."d ;,:.n ... � •{a. A' � ;.'.:. � '::� ���.� S ..�fE f.� 4 1'--4.
'- H F-iGwr: GAS:
CONDITiom : SEWER:
REMARKS : PAVED ST:
I '
NlF S N E"pA 2p
i
v
•�, I.P. 551'2Z'30'E i.II. q3
I-or 6os
40r 60(v 4 0 �oQ �
j 20,000
33
�0
7 l 9 �P
� y
I
OWN ER : —��N� -- i PLAN OF LAND
LOr 60& CTRE-EKFtELD Daive-- - --- -----__-_
--- _ --- ------- -- - ------_ DATE: tq(o8 CA,,L F 40Fr.'l
eq
HAMPDE N COUNTY 570K OF FLANS:
smlrH
I 'DF-E.o +vOK MASS. LiC. NO. ENGiNEER1NG CU4v P,� Nam ,' ivC:,
} -r m, -.� g WW E ,