HomeMy WebLinkAboutSeptic New 107 Hayes Road 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 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property/�����tiy/��✓ �d ill� �T1x_Address of Owner_&X ;1-0 1-f. 6J - /-1-41,
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2. Location of Property 07 Lot. No. C J
3. Type of Structure No. of Bedrooms ;?
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories / Bathtubs_
Showers_ Kitchen Sinks l Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank e d dg Material of Septic Tank �dD�tC, ��✓P
7. Soil Conditions: Type of Soil 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 OvZd�r
12. Leaching System: Number of trenches Length .7 Widtk� TotalG z►
Other
Signature ; �
(Licensed Ins&ller)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
LOT # E3
CORNEP, OF POPLAR HAYES ROADS
SOUTH WIN'OSOR , CONF4
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I HEREBY CERTIFY
THIS PLAN TO BE
SUBSTANTIALLY ENGINEERING AND LAND SURVEYING
CORRECT; 740 NO. MAIN STREET. CROSSROADS PLAZA
NO. *732 WEST HARTFORD 7. CONNECTICUT
1vy�*1STrIll-40"' j' rSCALE DATX REVI .
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