HomeMy WebLinkAboutSeptic New 65 Greenfield Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
&4,9AS4,1474 C,4A--YF WA4;1 Application
TO THE BUILDING DEPARTMENT: Date 2 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is sub 'tted: /
1. Owner of Property Address of Owner�2
2. Location of Property
Lot. No. ®._
3. Type of Structure No. of Bedrooms
(Dwel' g,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets o'P— Urinals d Lavatories ` Bathtubs
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic TankT
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,uravel,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 -g Length /S4- Fr Width2.45 r—'T Total /1",
OtherJD3?s
Signature
( icensed Installer)
(Sketch showing all minimum distances and other details required below)
NOTE: Per homeowners' request, delivered copy of septic plot plan on 11 April, 1975.
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
1
CONDITION s EwE R
REMARKS: PAVED ST:
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t4WNER: .�,., �.,� � ,� Eyy��OE�zS ---- - - PLAN OF LAND AT:
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So .�[ti(iND50R. c otyrl DATE: SCALE: t'�40-0
HAMPDEN COUNTY BOOK OF PLANS: _
,PAGE NO; LOT NO --- --
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DEED BOC3�c: MAS '. Lic, NO, ENGINEERING C-O"PA._ka*- INC.
�.�A G E N : 5394 602 v�, H rr E Syr 5 p ru ,s a r t , t:. ,