HomeMy WebLinkAboutSeptic New 189 Palmer Drive ,r
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System_
Application o.
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�° •Address of Owner Q.K l�ua .c�
2. Location of Property Lot. No. to`S✓
3. Type of Structure No. of Bedrooms_
( lling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ (� rifZ1
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers — Kitchen Sinks " Laundry Tubs — Garbage Grinder, _Other
6 Liquid Capacity of Septic Tank qQ O Material of Septic Tank ex—t
7. Soil Conditions: Type of Soil Maximum ground water table
(Band,Gravel,C ,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
� ors embankment
10. Percolation Tests: Time for 1" drop in soil test '/� Classification of soil
11. Minimum square feet of effective seepage area required t
i6 y� yio
12. Leaching System: Number of trenches_ Length _ Width � Total ``
Other
Signature
(LicerInstwier)
(Sketch showing all minimum distances and other 4 1equired below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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PROPERTY ON
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NO. PALMER DRIVE. SOUTH WINDSOR, CONN .
Being Lot No . 65 on map entitled "BIRCH HILL ESTATES Foster Street
South Windsor, Conn . Property of U R Hous-ing Corp. Scale 1" 100,
Date : Jan. 21 , IP63 Hayden L. Griswold C .E . "
Scale 1 " — 50 ' �J, y ory'
HAYDEN L. GRISIVOLD C.E.
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