HomeMy WebLinkAbout1965-12-22 - 24 Governors Highway - Septic Application�4WN 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—,1. 19 C' j'
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
+F-1 14
1. Owner of Property( r �- , d r d -s Yr L' [� Address of Owner
2. Location of PropertZy� 'L Lot. No.
3. Type of Structure lit—' , �t c `�f No. of Bedrooms.
(DwAdling. Commercial Bullding. Store, etc.) /)
4. Number of Families or Persons to Occupy Premises,
:i. Plumbing Fixtures: Water Closets - Urinals Lavatories--2— Bathtubs
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank t Material of Septic Tank �z Z� ^ t C'
7. Soil Conditions: Type of Soil i San , Gr-K' : -av .,Clay, etc.) Maximum ground water table
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 required
12. Leaching System: Number of trench —es Length Widtlx Total 5
Other
c'r
Signature � f _ �
eensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Ism
19 By,
Installation Completed, Inspected and Approved 19 By
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