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Home My WebLink AboutAs-Built 437 King Street 12/01/2016 16:53 18605289694 V SILVESTER PAGE 01/02 4 Town of South Windsor — Health Department 't'� 1540 Sullivan Ave.,South Windsor, CT 06074—Mailing Address 1530 Sullivan Ave.,South Windsor,CT 06074—Office Address s° Phone Number:(860)337-6173, Fax Number:(860)644-1930 SEPTIC SYSTEM AS-BUILT PLAN Date Permit Number Street Address'f 3 7 �1 _-- New Septic System Repair of Septic System Alteration of System Number of Bedrooms OR Design Flow of BuRding Type of System h0alled p �i` a""L (e.g.stone trenches,infiltrators,galleries etc.) Square Footage of System: Total Length Width Effective Leaching Area- Capacity of Tank— _/"�2 Tank: New_ Kdsting_ Length of House Seger Pi1w / Minimum Distance Between Septic Tank&Foundation- Minimum Distance Between Leaching Field &Foundation Minimum.Distance Between Sewage System&Nearest We Public Water Supply Minimum Distance Between Leaching System and Property Boundar.), Curtain Drain lZeyuired? - Minimum Distance From Leaching System to dralm- _- (curtain,foundation,storm watex,etc.) RECEIVED r� 212016 SOUTH WINDSOR HEALTH DEPT. ***DRAFT DRAWING ON REVERSE SIDE OF FORM 12/01/2016 16:53 18605289694 V SILVESTER PAGE 02/02 SEPTIC SYSTEM AS-BUILT PLAN (coaftwd) Address 7 �1-e ef Date_.f.�,�///� Location of Sys (N-s.E.W_,bYonc,sack) de of ltouse Draft a substantially correct drawing showing separation distances of septic system insallation. Include all of the following information to provide an accurate record of the entire system location: At least two sides of the building nearest the system,septic tank,house sewer, distribution boxes,trench ends,dry wells,curtain drain,potable water supply weds,and any other features affecting the system Jand its locations. Installer's Name eO)�, License# D/a Installer's Address 6 C A r S h"-2 f -5 t 17/gr t�©ro (ajeet,e4y,state,Ap code) Installer's Email L v c.5. 6 ro fi 01-1 � 3 r�rnnGn a.Fr. to eXis�ihs /SOD �ro�/Orj COI L`YC�P �o/Y/t Point #1 #2 #3 #4 #S #6 #7 #S Distan4e ZGow corner"A" • •g" 3/7 D cc fmm corner`0" Ajetanee from corner ,c- Distance from corner I'D"