HomeMy WebLinkAbout1967-12-27 - 20 Fox Meadow Lane - Septic ApplicationTOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor,Connecticut
Appllcatlon for Permit to Install or Repair Indmdual Sewage Disposal System #//b'
Apphcatlon No
TO THE BUILDING DEPARTMENT Date .l ’ILé’Z-‘f w g?19K“E”
A permlt ls requested for repalr or constructmn of an 1nd1v1dua1 sewage dlsposal system concernlng wh1ch the
following 1nformatlon 1s subrr1tted
1.Owner of Property .Address of Owner ”:3
1"}gghm.%¢riw J£wx lien?“ewes
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2.Location of Property
a/‘Ié‘q Lot.No.
No.of Bedrooms 2:l N
(Dwelling,Commercial Building,Store.etc.)
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3.Type of Structure v’?{£¢d#f§a;
4.Number of Fagilies or Persons to Occupy Prem’ises “g
5.Plumbing Fixtures:Water Closets Urinals 3 Lavatories §Bathtubs
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6.Liquid Capacity of Septic Tank Matenal of Septlc Tank
Showers £Kitchen Sinks -i Laundry Tubs 5:Garbage Grinder if!“Other
7.Soil Conditions.Type of Soil .fw“rt v gel Max1mum ground water table
(Sand Gravel Clayr §tc)
8.If not served by pubhc water supply Distance from Owner s well from adJacent well ”iit”
9.Distance to nearest water course,drainage ditch,storm dram or embankment “’7?MW;do
10.Percolation Tests:Time for 1”drop in soil test I Classification of soil
11.Minimum square feet of eEective seepage area requlred
12.Leaching System Number of trenches Length W1dth
Other I?Xm’wr’is f’r’we‘i'’Kr a»;““4;r‘?”
Signature 2'.
”T."W y.-J’ygégW f f;
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I}J Aw‘Qsr S )w J v “l y Vi Kimy’yd l V‘W
(Licensed Installer)
(Sketch showing all minim-um distances and other details required below)
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Permit Issued xx ,9 "ag'?I 19 (I;?By w‘y‘x ’as!E §a g ai:
OW 2"*;;*‘£’t£&.w£.aawwm:
Installation Completed,Inspected and Approved 19 By
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