HomeMy WebLinkAboutSeptic New 461 Miller Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
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Application No. lD�oL�
TO THE BUILDING DEPARTMENT: Date 19
A permit is requested for repair or construction of an individual sewage dis osal system concerning which the
following information is submitted:
1. Owner of Property b. Addres//sue�of Owner 7.
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2. Location of Property Lot. No.
3. Type of Structure No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ , 1 �- .A
5. Plumbing Fixtures: Water Closets Urinals 6 Lavatories Z� Bathtubs
Showers�j Kitchen Sinks—I Laundry Tubs_6 Garbage Grinder 0 Other
6. Liquid Capacity of Septic Tank Material of Septic Tank C
7. Soil Conditions: Type of Soil G'h k, v fA Maximum ground water table O
(Sand,Gravlel,Clay,etc.)
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8. If not served by public water supply: Distance from Owner's well from adjacent wells v
9. Distance to nearest water course, drainage ditch, storm drain or embankment 11:5,d 71'
10. Percolation Tests: Time for 1" drop in soil test �0 M //r Classification of soil
11. Minimum square feet of effective seepage area required /,SO
12. Leaching System: Number of trenches 3 Length /6"6 / Width d, If Total_,d0
Other
Signatur(12� 624�01�4mk
' (Licensed(LIcensed Installer)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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FOR BUILDING PURPOSES 0
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DENNIS M MOYNIH N
NO; MILLER ROAIk SOUTH '4IND;SOR, Gatti
. Gale 1" 50 ' June I8, 1 964
HAYDEN L GRISWOLD G .L. s A
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