HomeMy WebLinkAboutSeptic Repair 357 Griffin Road TOWN OF SOUTH WINDSOR 7� 4941
LTH DEP .�Mf N
Application for permit to install a ne repair u surface sewage disposal system. To the Health Department,
Town of South Winds r./
Fee Paid IO �c I 3� Date I X/6 T Permit Number
As a subsurface sewage disposal system installer licensed in the State of Connecticut, I
Arthur D. Breault-Violette Silvester & Sons-65 Cherry St-E.H. ,CT06108 289-3466 Lic#005349
Name, Address, Telephone Number, License Number
hereby apply for a permit to construct/repair a subsurface sewage disposal system located at
357 Griffin Rd - South Windsor andownedbySusan Lynch/Scott VanSicklin
Street, Address, Lot Number
8 Homewood Place - Wolcott CT 06716 Name
Address
Information to be supplied by Applicant:
Type of dwelling residence If non-residential, estimated daily flow
Residential,Commercial,Etc.
Number of bedrooms 3 Size of lot
Number of fixtures above basement 3 sinks - 2 toilets - 1 tub
Tubs,Sinks,Toilets,Etc.
Number of fixtures in basement, if any pone ,
Type of water supply If private, type of well Well 75 feet away
umped rgravityflow,
away
Public-Private
Information to be supplied by Health Department:
Soil type at various levels
Percolation rate Square feet of effective leaching area required
Size of septic tank Type of system
Trenches,Drywells,Etc.
Number of dry wells, trenches, etc. Distance between individual leaching
units. Distance from well on same property on adjoining property
Curtain drain required
Yes,No
Height of system above ground water maximum ground water
ledge , impervious soil layer
If automatic closing is required, description
A PLOT PLAN INDICATING LOCATION OF PROPOSED STRUCTURE, WATER SUPPLY, SEPTIC SYSTEM, EM-
BANKMENTS, WATERCOURSES, PROPERTY LINES AND ALSO INDICATING EXISTING AND PROPOSED
FINISHED GRADES MUST BE SUBMITTED BEFORE THIS PERMIT CAN BE ISSUED.
THIS PERMIT IS NOT TRANSFERRABLE FROM PERSON TO PERSON OR FROM PLACE TO PLACE.
NO PART OF THE SYSTEM SHALL BE BACKFILLED UNTIL IT HAS BEEN INSPECTED AND APPROVED BY THE
SANITARIAN.
SPECIFICATION AND REQUIREMENTS AS STATED IN THIS PERMIT MUST BE MET AND ANY CHANGES MUST
BE APPROVED BY THE TOWN SANITARIAN BEFORE FINAL APPROVAL WILL BE GIVEN.
THIS PERMIT SHALL NOT BE CONSTRUED AS PERMISSION TO CREATE A NUISANCE CONDITION NOR IS
THIS SYSTEM GUARWBYTH DEPARTMENT.
Permit Received byMGOS3 Date Ion-o91 1�'
Signature of Applicant&License Number
For Office Use Only
Permit issued by Date
System installed by
Final Inspection Approval �Akii,, Date
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