HomeMy WebLinkAboutSeptic New 42 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 Windsor.
Fee Paid -2,0 40-A Date 7_2-3-4Y Permit Number
As a subsurface sewage disposal syste installer licensed in the State of Connecticut, I
Name, Address, Telephone Number, License Number
hereby apply lfor a p rmit to co tr t/re air a subsurface sewage disposal system locat d at
�i 7�/tI,� �V �2T� and owned by Jac�u'2S Go Y�S.YI
Street, Address, Lot ber ��� Name
Address
Information to be supplied by Applicant:
Type of dwellin If non-residential, estimated daily flow
Residential Commercial,Etc.
Number of bedrooms Size of I
Number of fixtures above basement z.
Tubs,Sinks,Toilets,Etc.
Number of fixtures in basement, if any ,
umpe or gravity flow,
Type of water supply If private,type of well
Publi Private
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 bfignature
D� Date
of A icant& icens umber
For Office Use Only
Permit issu Date
System i
Final 1 n p roval Date
Ol i G p p SpS
�3
11
wpm
Y�ru,,Mw iI i
NOTES
I.THIS MAP IS DEPENDENT ON THE MAP REFERENCED HEREON.
2.PARCEL ZONED RR
3 UTILITY INFORMATION PROVIDED BY CONTRACTOR / I
/ 0 `
MAPREFERENCE-
I TEMPORARY CUL—DE—SAC
VINTAGE HILLS.SOUTH WNDSOR, CONNECTICUT. PREPARED FOR THIS PROPERTY REVERTS TO ABUTTING
BY DESt�q PR GALS taDATED 12-3-M REV. TO 7-16-02 PROPERTY OWNERS WHEN STREET IS
EXTENDED. PAVEMENT REMOVAL, GRADING,
SEEDING, EXTENSION OF CONCRETE
SIDEWALKS AND ALL OTHER WORK
INCIDENTAL TO REMOVING CUL-DE-SAC
ARE REQUIRED UPON STREET EXTENSION.
20' STREET TREE
EASEMOF THE TOWN IN FAVOR
`\ 10 SOUTH WINDSOR ( R=5b.00r / 1
L-3.23
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+ CONSERVATIOM EAS EDTN '08
IN FAVOR OF THE TO \ \
OF SOUTH WINDSOR ♦ \ zoo f! .45
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LIMIT OF k UPLAND \ +
REVIEW AREA X
_ � 24$.3� �
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THIS SURVEY AND MAP HAS BEEN PREPARED INACCORDANCE WITH SECTIONS 20-300b—T THRU 20-300b-20 � S78b�1'W
)•-( 1
OF THE REGULATIONS OF CONNECTICUT STATE AGENCIES — 'STANDARDS FOR SURVEYS AND MAPS IN THE LJ APPLNT: ` 1.7•
STATE OF CONNECTICUT" AS.ENDORSED BY THE CONNECTICUT ASSOCIATION OF LAND SURVEYORS, INC.INC THIS 1 JACQUES CONST R ON, LLC -
SURVEY CONFORMS TO HORIZONTAL ACCURACY CLASS A-2 - t 67 RHOS L TO THE BEST OF MY KNOWLEDGE AN BELIEF, THIS MAP IS SUBSTANTIALLY CORRECT AS NOTED HEREON. - SOUTH RIDGE
R, CT ROAD-' 74,�, _12882. -
TEL (860) 432-1823
-
RICHARD P. MARTEL LIC. No.
Recam As-d�.r
Tel. 860.291.8755 L UNLESS ASOTHERWISESHOWN NOTED,BASED
ON unuTY REVISIONS GRAPHIC SCALE w Fax 860.291.8757 Prepared tOR SHEET
LOCATIONS AS SHOWN ARE BASED ON 05�99■
AVAILABLE INFORMATION.ARE
ALL STAKEDaSyD
714E FIELD
- 4o O � +0 - Vints4re Hills j&w44* LLCSHOULD BE FlDD VERIFIED PRIOR TO CONSTRUCTION. t'Of eSSIOI'ta1S, Inc. ,g y
2 ALL UTILITIES ARE TO BE STAKED IN THE FlELD
BY A LICENSED LAND SURVEYOR PRIOR TO 111111116� OF
3. THIS LANN. ' civil engineers • planners . surveyors �t •yb ViutxgC $C DRAW Br. DMG Aas NO.: 7470-9
IMPRESSION
THIS PLAN IS INVALID UNLESS IT BEARS THE
IMPRESSION SEAL HAL ENGINEORIGN L SIGNATURE 1 inch = 40 feet landscape architects • gig • gps SOUTH WINDSOR
OF.THE PRacES51oNAL ENGINEER/SURVEYOR. NO. DATE DESCRIPTION BY 165 South Satellite Road South Windsor. Connecticut 06074 CONNECTICUT --Or* APM DALE.• 11/2/04