HomeMy WebLinkAboutSeptic New 45 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. U
TO THE BUILDING DEPARTMENT: Date ,Z _tf �cS 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: lq�
1. Owner of Property Address of �
2. Location of Property Lot. No.
.17
3. Type of Structure
welling,Commercial Building,Store,etc.) NO. Of Bedrooms
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets _ Urinals Lavatories_ Bathtubs_
Showers Kitchen Sinks Laundry Tubs _ Garbage Grinder Other
6. Liquid Capacity of Septic Tank �� aterial of Septic Tank
7. Soil Conditions: Type of Soi , Maximum ground water table f�
(Sand,Gravel lay,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 I.-XOtAa -Classification of soil
11. Minimum square feet of effective seepage area required ,oV
12. Leaching System: Number of trenches � Length �4 ' idth_ � Total
Other
Signatur;?er (Licensed Installer)
(Sketch showing all minimum distances and details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
• L AK
WI1. LI_AM LEAR
4_5__l_"__E._-STP,EET _- LOT 4
,_b_y: M._Edwards, Jr
_2 —69
N
30—6
r
�— 1250 Gal Tank
® PERC TEST HOLE
7 min per inch
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