HomeMy WebLinkAboutSeptic New 61 Hazel Street r 9
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. 7V
TO THE BUILDING DEPARTMENT: Date / 19
A permit is requested for repair or construction of an individual sewage disposal system concerningwhich the
following information ubmitted:
1. Owner of Propert Address of Owner
2. Location of Property Lot. No. :RJ
3. Type of Structure No. of Bedrooms cam
(Dwelling,Comme al Building,St re,
4. Number of Families or Persons to Occupy Premises_ /37
5. Plumbing Fixtures: Water Closets Urinals vatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Ta ��e-A2-
Material of Septic Tank If,Material ��
7. Soil Conditions: Type of Soil Maximum ground water table
(Band, v lay,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 /cD�
f
12. Leaching System: Number of trenches�� Length_ Widt � Total
Other /'�
Signature '�``�` f A °.,,�
(Idcensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
L-T 35
CORNER OF. POPLAR & HAZEL ROADS
SOUTH W I MIDS OR, 'OKK -- ^ kiI
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'1 WRE ARt' KG V3L0ATIOK:; OF
THE ZGMfIA� LA11V8 OF THE TOIAiMf II __ t Lli
OF` 34)UTW, *IIYQaOR.
LOT AREA; 10 , 4 n S, cAl
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POPLAR
ROAD, i
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HAZEL ROAD
k!J►P�R€fE BEIItCE i
GRAM'AM EgrArre aroT.#Ok. i�'
P R"O P E RT'r Off' M #FfiF '• H-blr r l .► „:4 a '.,
HAYEs AND NtCtjtaaE ROT :aOtitTH' 'h1�1��y3DR
CON1#. SCALE I:R".- 0� ,jUL ° 1956
r Mr6A L I;.t bllR• H M•I:S
SElAtTH W�t�iaS OR� COMi�f.
�� oR "►a I HEREBY CERTIFY —��jgp
THIS PLAN TO BE ,
"Z SUBSTANTIALLY .ENGINEERING AND LAND SURVEYING
CORRECT;. 740 NO. MAaN STREET, CROSSROADS PLAZA
tf�r58i1 WEST•HARTFORD 7,CONNECTICUT
DATA: REVS D
i+10=401 5/r k/64
T 6335