HomeMy WebLinkAboutSeptic New 00 Niederwerfer Road (6) R
TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
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 2� `> (J rS7 IK 1 Address of Owner :�,1,413
2. Location of Property N w 4 F r P e-# f lam' Lot. No. .
3. Type of Structure If LA-1 f /f 1 K y
No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
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4. Number of Families or Persons to Occupy Premises r
_ � f 2 vas i /ei
5. Plumbing Fixtures: Water Closets �� Urinals Lavatories_ Bathtubs ?�—
Showers Kitchen Sinks f Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 40 0 Cy Material of Septic Tank �a i'c �i,e "P
7. Soil Conditions: Type of Soil (2 i'2// e P Maximum ground water table_ /O
(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
ei t
10. Percolation Tests: Time for 1" drop in soil test oe /-.L S Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Total
Other
Signatur
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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Installation Completed,Inspected and Approved 19 By
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ELLINGTON ROAD (ROUTE 74)
I HEREBY CERTIFY THIS MAP TO
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IN ACCORDANCE WITH CLASS D „
CODE OF CONN. TECHNICAL COUNCIL INC. SURVEY FOR
• ALBIN ZAGORSKI
NIEDERWERFER ROAD SOUTH WINDSOR;
SCALE 1"=40' APRIL 1968`
WILLIAM J. CARRINGTON REG. L.S.
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ELLINGTON ROAD (ROUTE 74)
I HEREBY CERTIFY THIS MAP TO
BE SUBSTANTIALLY CORRECT AND
IN ACCORDANCE WITH CLASS D ,
CODE OF CONN. TECHNICAL COUNCIL INC. SURVEY FOR
ALBIN ZAGORSKI
NIEDERWERFER ROAD SOUTH WINDSOR
SCALE 1' =40' APRIL 1968
WILLIAM J. CARRINGTON REG. L.S.