HomeMy WebLinkAboutSeptic New 100 Mark Drive'70300100 ti
TOWN OF SOUTH WINDSOR
BUILDING DEPARTMEN-T
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. ,q
TO THE BUILDING DEPARTMENT: Date %/ ^</ 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]�AA . +p_ _. Addre of Owner
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2. Location of Property Lot. No.
3. Type of Structure _ No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ LVlw —
5. Plumbing Fixtures: Water Closets Urinals U Lavatories d� Bathtubs
Showers Kitchen Sinks Laundry Tubs O Garbage Grinder b Other
6. Liquid Capacity of Septic Tank--- Material of Septic Tank_
7. Soil Conditions: Type of Soil Maximum ground water table
(San avel,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 X� Classification of soil
11. Minimum square feet of effective seepage area required d
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12. Leaching System: Number of trenches __ Length Width 30 !' Total
Other
Signature
(Licensed Ins ler)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19_ By
Liz T 1
MARK ROAD - �\A /
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N/F TcVvN OF SOU TH di I r:O�,OR
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PAAP RErERENCE FLGT -LAN'
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RAVE'S ;VEV-PS :3()At)c . W INDSOR g CONN .
SCALE I M'= r` P J'- LY 4 1I>6 MOP TOM S. SINE IC.E.
REV IZED '-^ .E
I HEREBY CERTIFY
THIS PLAN TO BE
SUBSTANTIALLY ENGINEERING AND LAND SURVEYING
NO. 3732 CORRECT; 740 NO. MAIN STREET, CROSSROADS PLAZA
WEST HARTFORD 7, CONNECTICUT
tq,4FGISTS -O�
SURVE DATE REVISED D W
6335
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