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HomeMy WebLinkAboutSeptic New 115 Greenfield Drive TOWN OF SOUTH WI N DSOR BUILDING DEPARTMENT South Windsor, Connecticut Application for Permit to Install or Repair Individual Sewage Disposal System ��ZAcrCj 34rt" A + "rTrA. Application No. TO THE BUILDING DEPARTMENT: Date 19 A permit is requested for repair or construction of an individual sewage disposal system concerning which the following information is 7snitted: 1. Owner of Property i - 1�ddress of Owner 4 2. Location of Property �J.•�. P 'r c'-� c- �- �Y-h^L<, -c-1 Lot. No. 4/.2— 3. Type of Structure ` (W,r3'.,�, No. of Bedrooms J welling,Commercial Building,Store,etc.) 4. Number of Families or Persons to Occupy Premises_ '' ""` 5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs Showers _ Kitchen Sinks i Laundry Tubs Garbage Grinder Other 6. Liquid Capacity of Septic Tank &r"19 Material of Septic Tank �•�.=c '.::-t...E... 7. Soil Conditions: Type of Soil - a�'�?� 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 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 3 LengtWJ7 FT Width 2.S FT Total 341,,S4Pr Other f '� /j Signature ✓ > �J �•-r� (Licensed Installer) (Sketch showing all minimum distances and other details required below) Permit Issued 19 By Installation Completed, Inspected and Approved 19 By IHEIGHT: GAS: CON orriGa`J : $EWE R: R E. M AR K S : PAV E O ST: J 3 , . r t _ C� `A. OWNER: PLAN OF LAND A4': ©ATE: _ SC A,I—E.��._...: HA M P D E N COUNTY MBOOK OF PL,.AM No. LOT NO: WA PLAN Cr O 0K; • b-1i".. P4 GINEER3140. CC," �*,-4ue ii4c. .:om STi2UCTipN: WATE R -iEIGNT.� GAS: �ONO►CTi�1: __ SEWER: . , REMARKS: PAVED ST-. T. ��.i+dw.��� ..ate ,/L�/Jy/ t•' i H`iREBY CEF.TI"I" T i, S 1i 1P TO RE WRR-F�CT. A-',�I3 IN CL.SS. A2 Turi co l)F, C- W.'v N. TE 11:+i C 4 Egli`.-LL Iii C, 1. )WtNER: PLAN OF LAND AT: - —- - - 1AMPOEN COUNTY- BOOK .OF PLANS--%: -- --- � �►o�. No: r '9 ' too. �'µ MITE �SNALLE.II PLAK, N