HomeMy WebLinkAboutSeptic New 23 Lake Street 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_ /8 19 69
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 .,�e� td�r,el`, Address of Owner
2. Location of Property I -1�Z 3 Lot. No. ..Z
3. Type of Structure No. of Bedrooms_
(Dwelling,C(Pnmercial Building,Store,etc.)
4. Number of Families or Perseas to Occupy Premises_ /
5. Plumbing Fixtures: Water Closets --A- Urinals Lavatories -:'x- Bathtubs _
Showers_ Kitchen Sinks _ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank a S'A Material of Septic Tank o a`
7. Soil Conditions: Type of Soil ,� Maximum ground water table-
(Band,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 1. :z Classification of soil q P
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches -7-- Length 1162 Width, Total
Other
Signature
(Lice used installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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