HomeMy WebLinkAbout1964-3-26 - 1245 Ellington Road - Septic ApplicationTOWN OF SOJTK WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application Na.
Date �- � �z,6 19. Wy
TO THE BUILDING DEPARTMENT
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
�._ Address of Owner She
1. Owner of Property.
Lot. No.
2. Location of Property of ' +
No. of Bedrooms -
3. Type of Structure - (Dwell, Commerclo Building. Store, etc.)
4. Number of Families or PersntoccuPremises ypy j Bathtubs
5. Plumbing Fixtures: Water Closets -
Urinals__ Lavatories
Other
Showers
Kitchen Sinks __ Laundry Tubs Garbage Grinder
gnk o a —Material of Septic Tank
. Liquid Capacity of Septic Ta
Maximum ground water table_
7. Soil Conditions: Type of Soil and, a�el, C y, etc.}
R. If not served by public water supply-. Distance from Owner's well -from adjacent wells
9.
10.
11.
12
Distance to nearest water course, drainage ditch, storm drain or embankment
Classification of soil
Percolation Tests: Time for 1" drop in soil test
Minimum square feet of effective seepage area required ' Total �z
Leaching System: Number of trenches_—
Length Width
Other_--— — — —
(Sketch showing all minimum distances and other details requirea Delow,
Permit Issued_ _ -- —
19 BY
Installation Completed, Inspected and Approved
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