HomeMy WebLinkAboutSeptic New 40 Hazel Street i
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. �oZ O 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 d / Address of Owner
2. Location of Property Lot. No.C�s
3. Type Of Structure NO. of Bedrooms
Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ 07l '
5. Plumbing Fixtures: Water Closets oZ Urinals U Lavatories / Bathtubs /
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6 Liquid Capacity of Septic Tank aterial of Septic Tank
l
7. Soil Conditions: Type of Soil Maximum ground water table
(Sa travel,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 V drop in soil test �— Classification of soil
11. Minimum square feet of effective seepage area required 7Jr
12. Leaching System: Number of trenches Length Width i� Total
Other a /�
Signature 7�—
(Licensed Installer
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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OF THE TOWN OF SOUTH WINDSOR,
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MAP R"ErEOENCE:
GRAHAM ESTATES SECT�C,y
PROPERTY CF MuPPAy
HAYED ANC NFVER �" " S c � 1;`
WIN7SCP , CiJNN SCAL'r ' -�, ' ' l. b rr PLOT PLAN
M -S . FINF , C. E • FOR
MECALL I'ON HCMES , INC.
SOUTH WINDSOR ,CONN .
I HEREBY CERTIFY
�x THIS PLAN TO BE
p � ay SUBS TANTaAL.LY ENGINEERING AND LAND SURVEYING
CORRECT; 740 NO. MAIN STREET, CROSSROADS PLAZA
WEST HARTFORD 7, CONNECTICUT
SCALE
DATE REV SE D W
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