HomeMy WebLinkAboutSeptic New 45 High Ridge TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal Systern-,4/f ',
Application No.
TO THE BUILDING DEPARTMENT: Date. 2— —/lrJ 19_ 7
A permit is requested for repair orconstruction of an individual sewage disposal system concerning whit the
following information is submitted: �a r-1 ,nQPar�C
1. Owner of Property - t Address of Owner s <} de I�
2. Location of Proper c I r'VA M121JOG-1 aD Lot. No.
3. Type of Structure No. of Bedrooms__.;,
(Dwel ng,Commercia uilding,Store,etc.)
4. Number of Families or Persons to Occupy Premises
5. Plumbing Fixtures: Water Closets Urinals Lavatories_ Bathtubs
Showers_ Kitchen Sinks_ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Ud Material of Septic Tank C i t< e, r�
7. Soil Conditions: Type of Soil J&rev,C 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 a/
12. Leaching System: Number of trenches Length R Width Total
Other ..
Signature
(Licensed Installe
(Sketch showing all minimum distances and other details requir ow)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
'w:;.;✓" �.SiS yy tqP MOO 141 '7`MrrYttiP
i'f�•1P � t� etr:fr..�d}5,i�. ��:12•ia;•,•? :i�.�1
y
. .ice:
+
1 ram / SOS
1
ti• ,// � f L (y�..�.. A.t t. Imo.41,
PROPE 'TY OF
PO HiON. ,,; IDGE 1"'OA ?
fie i nq Lo-t No . 2C` on .mad, entitled "t an of ORC114 RO 41El.CHTS. Avery
treet South Windsor, Connect i cut 3ca i e : 1 40' Ma 20, I
Ilk
Ha\ der, 'L. Or i swo l d Co. E, Sheet 2 of 3•,,
c a s e it:,rrlify lid
.�
j
yy i ;crt ,�,,1 i-�` HAYDEN L. Gf;;t6WC'I.D i,. C . r� � ,
.: �.t Z'a1y.3 P���7.2., k��. ���S�r'iYy,�.a tom'. ,, �.,�.a f �c ,. �_" �, w �•n ,�'�.