HomeMy WebLinkAbout1967-4-10 - 112 Gordon Drive - Septic ApplicationTOWN OF SOUTH Wl N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date 19I
A permit is requested for repair or construction of an individual sewage disposal system concerning which
following information is submitted:
1. Owner of Property 2ddress of Owner
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2. Location of Property - v l% Lot.
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3. Type of Structure i ° L y., No. of Bedrooms
(Dei ing, Commercial Building, Store. etc.)
4. Number of Families or Persons to Occupy Premises— r
5. Plumbing Fixtures: Water Closets _�2— Urinals Lavatories 2 Bathtubs`/
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder 0$her
6. Liquid Capacity of Septic Tank d 6' Material of Septic Tank_
7. Soil Conditions: Type of Soil ___ _Maximum ground water Eai.)leG v�-C
[Sand, Gravel, May. etc. )
8. If not served by public water supply: Distance from Owner's well from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test :;;—? , -2 - Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Total
Other
Signa
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(Licensed In$taller )
(Sketch showing all minimum distances and other details required below)
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Permit Issued _ _ 19 By,
Installation Completed, Inspected and Approved 19 Byr
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P1\OPERTY OF
NO. ALAN DRIVE ' SOUTH WINDSORF CONN.
Being Lot No. 21 on map entitled "Property of Rolling Park Homes,
Inc. South Windsor, Conn. Scale I" - 60' January 10, 1957"
Scale 1" 40'
HAYDEN L. GRISWOLD C.E.
FOR BUILDING 1)1°130SES ONLY