HomeMy WebLinkAboutSeptic New 33 High Ridge Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal Systen%"I"IYX
Application No.
TO THE BUILDING DEPARTMENT: 19�
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submit ' �t o�tct ass!
1. Owner of Property Addr_(ess of Owner �^'_ �f / +C►�
2. Location of Property <' �m ,e 1 .33 iz Ro.4 Lot. No.
3. Type of Structure LAJ'e �J 0 No. of Bedrooms
(Dwelling,Commerci Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closet _Z , Urinals Lavatories G.•— Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank Ca e)G Y e- rV 0�
7. Soil Conditions: Type of Soil 5 a"V 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 dWn or embankment
10. Percolation Tests: Time for 1" drop in soil test Clas ' ation of soil
11. Minimum square feet of effective seepage area required_
12. Leaching System: Number of trenches Length Width Total
Other
Signatur
(Licensed Installe )
(Sketch showing all minimum distances and other details requi below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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PROPERTY OF
�x4'IY 1f�1 f U�NO . 141 GH lk I DGE ROAD SOUTH w I ND!S01", CONN
Ede i ng Lot No. 21 on map entitled "Plan of C.f'CNARP Livery
Street - South Windsor, Connecticut Scale : 1 " - 40 ' Ir;ay 2C, 1065
Hayden L. Griswold C. E. Sheet 2 of 3,;
Scale 1 „ 40,
HAYDEN L . GRISWOLD C. E .