HomeMy WebLinkAbout1970-8-3 - 1005 Ellington Road - Septic ApplicationTOWN OF SOUTH W I N DSOR p���►r
if'q�p BUILDING DEPARTMENT
BY ;4; y South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. 0003740 ^ /
TO THE BUILDING DEPARTMENT: Date $ .3 A. 4� 19_7_,3_
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted "IQ" 43 1. Owner of Property=�Y _Address of Owner1a,vS Et1tWIGT0y%l apik-b
2. Location of Property ASAAtQ7^ _ _T _ _ Lot. No._
3. Type of Structure rl No. of Bedrooms__ _
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises ON C e t j 1=— A..L I 1, _
5. Plumbing Fixtures: Water Closets Urinals _^ _ Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Oilier-
6. Liquid Capacity of Septic Tank j01010 ! .4L"i l Material of Septic Tank _
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand, Gravel, Clay, 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 or embankment
10. Percolation Tests: Time for 1" drop in soil test__ Classification of Soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches 6At& 40) Length 30 FT Width Qt S FT Total —7S' F
Other
' Imlow )
Sc o JE/Z -"/2 SK'v704.
Permit Issued 40 a.�Wcit+aT _19- B/�
Installation Completed, Inspected and Approved og f ki - r15T _ _ 1976 BV�44 . � c►;� _
;oI
TOWN OF SOUTH WINDSOR
HEALTH DEPARTMENT
Application for permit to install a new epair fsLibsurface sewage disposal system. To the Health Department,
Town of South Windsor.
Fee Paid _ Date �l� &-1, I( - '41 Permit Number
As, a subsurface sewage ,disposal system licensed in the State of Connecticut, I
Narhe— - Address,
hereby apply for a permit to
5 al, $Zdress, Lot Number
Address
cCtlrepair a
Information to be supplied by Applicant:
Type of dwelling /L&-j
Residential, Commercial, Etc.
Number of bedrooms ` j
Number of fixtures above basement
Number of fixtures in basement, if any
,J
Type of water supply
Public-Privat
7alaphnne Number, License Number
subsurface sewage d s osa�, system Io ated at
and owned by ^ x
Name
. If non-residential, estimated daily flow
Size of lot % 7�
Tubs, Sinks, Toilets, Etc.
Pumped orgravity flow,
If private, type of well 1 �.a.,
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_
Number of dry wells, trenches, etc.
units. Distance from well on same property
Curtain drain required
Yes, No
Height of system above ground water
ledge , impervious soil layer
If automatic closing is required, description
Trenches, Drywells, Etc.
. Distance between individual leaching
on adjoining property
maximum ground water ,
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 by zz�,.,•. ��.� .� Cj, -,Y�. Date
Sign@}ere of Applicant & License Number
For Office Use Only
Permit issued by
System installed by
Final Inspection Approval
Date
_AR 4Q-�—� Date