HomeMy WebLinkAbout1970-6-4 - 100 Gray Road - Septic ApplicationYW ►0,410 TOWN OF SOUTH WI N DSOR IrF•ewr,r
4P0,09 ho BUILDING DEPARTMENT 14.-742-,
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No._ o 44VV-A0- 3
TO THE BUILDING DEPARTMENT: Date_ Or vTd WAr 19 70
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: b e n n l s E:u; L n g
1. Owner of Property A Address of Owner
2. Location of Property 1 J,0 G',4.4V , 4DEC#"4 FAM 3 Lot. No. •� % _
3. Type of Structureftw"►4_ A _ _ _ . No. of Bedrooms_ .9
4. Number of Families or Persons to Occupy
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 00 14"*04; Material of Septic TankFTE_
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 we11dFWA+44. #rom adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test r *"1At4I rE4► Classification of soil
11. Minimum square feet of effective seepage area required►4S Or 04FA ► ab " M T—~ eX S/9T *Sel
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12. Leaching System: Number of trenches I "A" ci) Length 42,0& P:r Width 2 • SKr TotalSeo FT
❑ther.
Signature _ .�
pLicensed I e
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(Sketch showing all minimum distances and othe a ai s require aw)
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Permit Issued _ 4W JAUwwC- 19 70
Installation Completed, Inspected and Approved /S V,*w w 194 By
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FOR BUILDING PURPOSES ppAr
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TOWN OF SOUTH WINDSOR
TOWN HALL
SOUTH WINDSOR, CONN. 06074
DEPARTMENT POLLUTION CONTROL
Date . !?
The Sanitary Sewer ..... _ .. ,`Septic Sg�ten% ...
at J� i`'.... . . . . . I11>. r. ...
or lot # ... .......... has been installed and completed
in accordance with the Town of South Windsor ordinances
and regulations.
Accepted and Approved
By _— _ - Date -