HomeMy WebLinkAbout1967-8-20 - 23 Gordon Drive - 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_
A permit is requested for repair o construction of an individual sewage disposal system concerning whit the
he
following information is subm1�41_e_1444_
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1. Owner of Property 24c'Address of Owner
2. Location of Property 1'4--C+•�44 Lot. Na.
3. Type of StructureNo. of Bedrooms
(DwCommercial Building, Store, etc.)
4. Number of Families or Persons to Occu
PY Zemises
_ -15c-e,�4.4 -
5. Plumbing Fixtures: Water Closets Z Urinals Lavatories Bathtubs —
Showers_Kitchen Sinks el Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank IL106 Material of Septic Tank L- -•r' _
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 we" --
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 required
12. Leaching System: Number of trenches Length Width /.. Total
Other
Signature
( Licensed Installer)
(Sketch showing all minimum distances and other details required below)
S�A;VryFO
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By,
Tuft 3U{LUl :..G PURPOSES ONLY
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