HomeMy WebLinkAbout1963-11-5 - 100 Mark Drive - Septic As BuiltTOWN OF SOUTH WINDSOR
BU l LDI NG DEPARTMENT
South Windsor,Connec ticut
AppEication for Permit to lnstall or Repair lndividuol Sewage Disposal System
Apphcatlon N o 7%?8
TO THE BUILDING DEPARTMENT:Date //{”43 19
A permit is requested for repair or construction of an individual sewage disposal system concermng which the
Owner of Propert
following information is submitted:
y if s/Address of Ownery100LocationofProperty)7Z&¢%&’£%/r/vtvd/c%)\Xvzégym/Lot.No.//l/
Type of Structure A/a/W No.of Bedrooms k5)
4.Number of Families or Persons to Occupy Premlses _@719
(Dwelling,Commercial Building.Store,etc.)l
5.Plumbing Fixtures:Water Closets Urinals (r?Lavatories oi Bathtubs /
Showers I Kitchen Sinks /Laundry Tubs 0 Garbage Grinder C?Other
aterial of Septic Tank //7 Z/C/Zr2k6.Liquid Capacity of Septic Tan
7.Soil Conditions:Type of Soi aximum ground water tabl
San ,G avel,Clay,etc.
8.If not served by public water supply:Distance from Owner’s well from adjacent well
9.Distance to nearest water course,drainage ditch,storm drain or embankment
10.Percolation Tests:Time for 1"drop in soil test ’Jim/0 Classification of soil £
S1gnature g m
(Licensed Instaner)
(Sketch showing all minim-um distances and other details required below)
Permit Issued 19 By
Installation Completed,Inspected and Approved 19 By
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11.Minimum square feet of effective seepage area required.
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12.lLeachingSystem:Number of trenches Length ’«‘3 L/Width'ii Total -;§
Other
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I HEREBY CERTIFY
THIS PLAN TO BE
SUBSTANTIALLY
CORRECT;
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Katy-7 '.%
ENGINEERING AND LAND SURVEYING
740 NO.MAIN STREET.CROSSROADS PLAZA
WEST HARTFORD 7.CONNECTICUT
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3-“:43"
i DATE REV;_SED DRWG.NQ.
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f IO/7/63 6335
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