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TOWN OF SOUTH WI N DSOR
BU 1 LDLNG .'DEPARTMENT
s South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No
TO THE BUILDING DEPARTMENT: Date /G
A permit is requested for repair or construction of an individual sewage disposal system concealing which the
following information is submitted:
1. .Owner of Property f11 Y 1 e'c '11 Address of 'Owner,` _ - /1�,O v-41/i P-e /
2. Location of Property �Jcs e c f`h� S tq� l9¢'E// Lot. No.
3. Type of Structure D W f' J No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons- to Occupy Premises_ �Llw
5. Plumbing Fixtures:_ Water Closets Urinals Lavatories _ Bathtubs _
Showers — Kitchen Sinks- Laundry Tubs 'mm Garbage Grinder Qther
6. Liquid Capacity of Septic Tank d'�Z/ Material of Septic Tank Y-1 C, ��
7. Soil Conditions: Type of Soil I S1 Maximum ground water table 1611j C CL f
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well f`ro/m adjacent wells
9. Distance to nearest water course drainage ditch storm drain or embankment ��0 r ��1 F��r E'- � h
, g i ��
10. Percolation Tests: Time for 1" drop in soil test C Classification of soil A
11. Minimum square feet of effective seepage area required sO"-J �'
12. Leaching System: Number of trenches \3 Length Width c Total �s
Other
Signature. i '7 1[ z
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 0 19 By
LOT '
SOUTH W 1,11 3S Ol PCONN O
LOT AREA = 20#209
T!4E?!E ARE NO i/ fcrI t 1f vS
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HILiiIDE:
8USOIVI ICN MAP
GO*mAM Es-i.TES r'RO-EmTY OF F
MURRAY HOMES INC. SOUTH 1ki;tNJSCS'
CNN CONSTRUCT f CN SECTioN# 4 PROPOSED tAV'3 1iT
LOTS 3c., 45 To 50 62 TO 66 FOR
m%. FINE C. w. 4-- 12-5_ 9 �&F 4crvsTR�rcT ttJar c �. INC.
3OUTH IWIt ,SOR�CCNN.
1 HEREBY CERTIFY
l,;`,! THIS PLAN TO BE SUBSTANTIALLY ENGINEERING AND LAND SURVEYING
' CORRECT; 740 NO. MAIN STREET, CROSSROADS PLAZA
�Ip Nt . 9732 l WEST HARTFORD 7. CONNECTICUT
DATA: R ,VISED
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