HomeMy WebLinkAbout1964-10-1 - 2299 Ellington Road - Septic ApplicationTOWN OF SOUTH WI 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 Lt _1.9
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 • t GC Address of Owner
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2. Location of Property r Lot. No.
3. Type of Structure >'� �- No, of Bedrooms.
4. Number of Families or Persons to Occupy Premises " t!�kQ -
5. Plumbing Fixtures: Water Closets /L Urinals Lavatories 2 - Bathtubs_.%
Showers Kitchen Sinks .. Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank % _' Material of Septic Tank �/1zLo
7. Soil Conditions: Type of Soil Maximum ground water table -
(Sand, Gravel, Clay, etc.)
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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 Classification of soil
11. Minimum square feet of effective seepage area requ
12. Leaching System: Number of It t i)chcs
Other
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Width �� Total �
(Sketch showing all minimum distances and other details required
Permit Issued
19 By
Installation Completed, Inspected and Approved _ .. 19 By
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