HomeMy WebLinkAboutApplication 160 Chapel Road o o S�hJV j ®y am.u,�
°w" •�,<-� Town of South Windsor — Health Department
pia 1540 Sullivan Ave., South Windsor,CT 06074—Mailing Address
1530 Sullivan Ave., South Windsor, CT 06074—Office Address
�•ti �` Phone Number: (860) 337-6173,Fax Number: (860)644-1930
�01-` B100a APPLICATION
(for building conversion,change of use,building addition,accessory structure and lot line change)
Standard application review time is 5-10 days,if soil testing is needed additional time will be required to com lete the review process.
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Street Address of Prdposed Activity/Structure
Owner Nalne Mailing Address Telephone
Applicant Name(if different than owner) Mailing Address Telephone
Describe the proposed structure or activity with dimensions:
Residential >-7 Number of existing bedrooms SOUTH WINDSOR
Non-residential Please describe M!~ALTH.DEPT
Property served by on-site well? f�Y N If No,List name of water cons pa ny
Property served by septic system?ON Age of system /�f Date last pumped
Plot plan—attach a scaled drawing showing property lines and dimensions,location and size of existing and proposed
structures, and site features such as driveways,wells and septic systems, drains and water courses.
Building plan—attach a sketch/floor plan of the proposed structure, addition or renovation showing existing and
proposed rooms with door and window locations.
Soil test data(deep test pits and percolation test) are required for the review of this application.
If the data is NOT available,you will need to schedule an appointment with the health department for soil testing.
As property owner or duly authorized representative of the property owner of the above referenced property,I agree to allow the
health department staff to enter the above referenced property as part of this B 100a application review process.I further agree that
this authorization to enter the subject property may extend through a period of time ending with the final B100a application
approval and affirm such m si nature below
Applicant Signature: Date: S Z y —�
FOR OFFICE USE ON
Approved: N By: / c ate• 3� /
Comments/Conditions: �� ,C%c�.s.— '� 4 .4
OR
May 2011
SURVEY( OF LOT NO.
PROPERTY OF
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SCALE " = 40 DATE:- /9 7 7
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1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074
J�Osoa c�rr TELEPHONE (860) 644-2511
May 30, 2017
Sandy Jarvis
160 Chapel Road
South Windsor, CT 06074
B-100 Application
SUBJECT: 160 Chapel Road,Above Ground Swimming Pool
Dear Ms.Jarvis.
On 5/25/17 this department received an application proposing the installation of a 27' above ground
pool to your property.
Based on the information provided and paperwork in our files this request has been approved under the
following conditions:
Maintain a minimum 10 feet distance from existing septic tanks and leach field from the proposed
_pool.
Approval is being granted under Section 19-13-6100a of the CT Public Health Code. This approval is
given with the understanding that you will provide proper care and maintenance of the existing system.
THE OWNER IS RESPONSIBLE TO SEEK PROPER AUTHORIZATION FROM ALL TOWN AGENCIES PRIOR TO
START OF CONSTRUCTION.
Should you have any questions, please do not hesitate to contact me at 860-337-6182
Sincerely,
Diane L. Collelo, REHS/RS
Town of South Windsor Health Department
CC:Town Planning and Zoning