HomeMy WebLinkAbout1966-12-14 - 230 Burnham Street - Septic ApplicationTOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
T' d-� V Applicati n N9.
TO THE BUILDING DEPARTMENT: Date r G ,, 19
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 Address of Owner J }
2. Location of Property ? Lot, No,
3. Type of Structure U No. of Bedrooms
f w.Ju. Comrn erciat Butldln�_ RtnrA .r, s
4. Number of Families or Persons to Occupy Premises �L
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic 'Tank 4729 ' d Material of Septic Tank
7. Soil Conditions: Type of Sail Maximum ground water table
{ nd, Gravel, Clay, etc.) ,
8. If not served by public water supply: Distance from Owner's well LILI 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 `� r-► C`.Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length T� Widt { Total s
Other
,Signature
1
(Licensed Installer )�
(Sketch showing all minimum distances and other details re wired below)
,► _4 N .
«o
I
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By