HomeMy WebLinkAboutScanned on 03/03/2010 at 14:58:50 TOWN 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: Date �� 190
A permit is requested for re ZZ
uction of an individual sewage disposal system concerning which the
following information is sub itted: ter,,
1. Owner of Property Address of Owner_ .
2. Location of Proper Lot. No.
3. Type of Structure l No. of Bedrooms
J (Dwelling, mercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Pre ses_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers_ Kitchen Sinks / Laundry Tubs_ Garbage Grinder/V yr° Other
6. Liquid Capacity of Septic Tank Material of Septic Tank CW<-, z44 J Qa
7. Soil Conditions: Type of Soil t5;9/tL/ Maximum ground water table
(Band,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's wel from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment_ �4
10. Percolation Tests: Time for 1" drop in soil test 4 '�''u;e'.Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length � Width a /off Total .3�0
Other
Signature / f r
(Licensed installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
PLOT PLAN FOR
i JAMES MILKIE
SOUTH WIHDSOR, OONN.
Seals Apr.1 5, 1 964
r
N
Note ;
There is ro building built
Therefore therels r.o violations
of th � zonirp, ordinances .
91
(V
.. 1
\ �A
v41STOt t'"1
�vE,l l61EREBY CERTIFY THAT THIS MAP
IS SUBSTANTIALLY CORRECT
:T.-