HomeMy WebLinkAboutSeptic New 12 Vintage Lane TOWN OF SOUTH WINDSOR
HEALTH DEPARTMENT
Application for permit to install a new/repair subsurface sewage disposal system. To the Health Department,
Town of South Wind or
23g3
Fee Paid Z0 Date �' o Permit Number
As asubbs�urface sewage disposal system installer licensed in the State of Connecticut, I
r bs
Name, Address, V Telephone Number, License Number
hereby apply for a permit to construct/repair a subsurface sewage disposal system to ated at
and owned by S'f4m� s 1� Z ey_u-e_
Street, A6d'rqV Lot Number Name
Address
Information to be supplied by Applicant:
Type of dwelling If non-residential, estimated daily flow
esidential, ommercial,Etc.
Number of bedrooms / Size of lot
Number of fixtures above basement d � -
Number of fixtures in basement, if any , Tubs Sink(,Toilets,Etc.
Pumped or gravity flow,
Type of water supply If private,type of well
Public- rivate
Information to be supplied by Health Department:
Soil type at various levels
Percolation rate Square feet of effective leaching area required
Size of septic tank Type of system
Trenches,Drywells,Etc.
Number of dry wells, trenches, etc. Distance between individual leaching
units. Distance from well on same property on adjoining property
Curtain drain required
Yes,No
Height of system above ground water maximum ground water ,
ledge impervious soil layer
If automatic closing is required,description
I
A PLOT PLAN INDICATING LOCATION OF PROPOSED STRUCTURE, WATER SUPPLY, SEPTIC SYSTEM, EM-
BANKMENTS, WATERCOURSES, PROPERTY LINES AND ALSO INDICATING EXISTING AND PROPOSED
FINISHED GRADES MUST BE SUBMITTED BEFORE THIS PERMIT CAN BE ISSUED.
THIS PERMIT IS NOT TRANSFERRABLE FROM PERSON TO PERSON OR FROM PLACE TO PLACE.
NO PART OF THE SYSTEM SHALL BE BACKFILLED UNTIL IT HAS BEEN INSPECTED AND APPROVED BY THE
SANITARIAN.
SPECIFICATION AND REQUIREMENTS AS STATED IN THIS PERMIT MUST BE MET AND ANY CHANGES MUST
BE APPROVED BY THE TOWN SANITARIAN BEFORE FINAL APPROVAL WILL BE GIVEN.
THIS PERMIT SHALL NOT BE CONSTRUED AS PERMISSION TO CREATE A NUISANCE CONDITION NOR IS
THIS SYSTEM GUARANTEED BY THE HEALTH DEPARTMENT.
Permit Received bypSignat
�� ` 0QS5 �_ Dateof Ap(i canP
ense Number
For Office Use Only
Permit issued by Date
System installed by
Final Inspection Approval A-,k Date
I
r7 �
i
Yl t z12
--- -- 3.7
77t
13
j
t
}
1
t �
�_2 WATE�t MAIN tiles
IW M&P EA93 ENT
00 TF:314. 3 �G \ 2 a � T IH FAVOR OF
-_ lilE TOWN OF SOU1H
309.59 W
4 CONC. i
"'
� 176.00
-
- l'UlIC.OAIIFRr — - .-
I
lY o_wx NIV.�31SOi '
\) W..-Si p MV.M.JISN - 10Pi11S5�—
` W.wUel-31s7 1
Xp4M
l � 4 -
_ �4 50' F.Y. z 1
I1 I �:= 1, 1 er our-3,a43 t
,318
O I O 1 10.0 t4.3 46.0 1
r \ 1 a0 1
M
0 N Q t Lot #1
1 1
EXISTING HOUSE
FF-320.57 1
1 INVERT�3„134 TOW=319.16
IN T 31. .�F
.W FF GAR=318.52 N
0' RCP H 4J
TAI`T ro i o'ODI
It
Ij
1 I DECK QN
20' DRAINAGE EASEMENT IN 314-
10' I FAVOR OF THE TOWN OF
50U-T1+WINDSOk 50' R.Y.
-312- .�cueas
OMIT OF 80'
REGULATED
411390 S.F. 1`` WETLANDS
` 0.9.4 Ace 176.00� ` BUFFER
- PROPOSEQ DETENTION-BASIN ACCESS ROAD
C"- -
o Open Space
Ii
---Tel. 860.29 t•8 AS-OMT
755 PREPARED FOR:
Fax 860.291.8757 pB�/ �g• SHEET
esi
fe s
ofessionals inc. VZYTACE SILLS MTA nW LW LOCA d�lSi117LN �
vii engineers . planners • surveyors L0T*2 " 1. VINTAGE LAW DRAB'Or VMG "NO.:14M OF
ndscape architects • Cis •gps . 1
Satellite Rood, South Windsor Connecticut 06074 $O CONNECTICUT CA'W Bi: NW DAIS 8/25/0.T