HomeMy WebLinkAbout1969-9-2 - 11 Greenfield Drive - Septic ApplicationTOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Dakt_
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property Address of Owner
2. Location of Property ��' t Lot. No.
3. Type of Sh-Licttire_ F' r No. of Bedrooms
(Dwelling, Cornm8-JarBunding. Stare, etc.)
4. Number of Families or Persons to Occupy Premises 6_�
5. Plumbing Fixtures: Water Closets ' Urinals — Lavatories_ _ Bathtubs %
Showers Kitchen Sinks�Laundry Tubs Garbage Grinder _ Other
6. Liquid Capacity of Septic Tan Cl o d Material of Septic Tank _
7. Soil Conditions: Type of Soil�ti r Maximum ground water table
i 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 to I MI.4 Classification of soil
11. Minimum square feet of effective seepage area required I *P � p a c,r^
12. Leaching System: Number of trenches Length /49 F7 Width 2, S FT Total4ZOS4 rT
Other j
Signature- d sy� t Lr c
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
SCAIVIqVED
Permit Issued 5�_' ►�'k h f-
19,09
Installation Completed, Inspected and Approved - 1q 1 G i' l9 L
UNITS:
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ELECTRIC:
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SEWER:
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OWNER:
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HAMPDEN COUNTY BOOK OF PLANS:
LjOT NO:
SEE-C BOOK:
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PLAN OF LANO .AT : _
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