HomeMy WebLinkAboutSeptic New 175 Lake Street } TOWN OF SOUTH W'I 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
A permit is requested for repair or construction of an individual sewage dis, sal sysjr concerning which the
following information is submitted:
1. Owner of Property ddress of Owner
2. Location of Property1 5_ Lot. No. -
3. Type of Structure No. of Bedrooms 13
(Dwelling, .,90fimercial Building,Store,etc.)
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 or% Q 6 aterial of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table_
(Sa 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 V drop in soil test 1 L Classification of soil
11. Minimum square feet of effective seepage area required C- /
12. Leaching System: Number of trenches Length Width Total
Other
Signature
(Lic n s Her
(Sketch showing all minimum distances and at r details require below)
Permit Issued 19 By
Installation Completed, Inspected and Approved —10— By
_ l F
! � 9
ai
� t 1
Air
-tom/6/ iti ��/�pp pp���������� pp''++�p
/ FOR D{J11.1FAi�M PYW
I'R(IrV1\1TY OF
J
f
NC . I AKF STREET W I NIA:Cal? , CCNN.
heinq Lot No . 2 on mar entitlod Plan of I'APAPISE
LAKES section It Lake Streuet £- iAhhv Road youth Wind!ior, Connecticut:
,c a l e. :. I " 4 ' March 12, 1 06' Gr i .,w+) l df% ".npj jeer ► nq, Inc . "
GR I SWC LP EN ,I NEED I N I NC�.