HomeMy WebLinkAbout1965-11-4 - 14 Grace Road - Septic ApplicationTOWN OF SOUTH W1 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 2 v
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 Q 11l � ~ !Address of Owner% C7 Y CSC: c r r
2. Location of Property ci _ Lot. No.
3. Type of Structure z No. of Bedrooms_
( Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand, Gravel, Clay, etc.)
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
J �
12. Leaching System: Number of trenches�Length y Width_ Total
Other
Signature r-1
(Sketch showing all minimum distances and other details Wequired below)
UJ 1,," -,%,v tl l,C� CJ I c 0 r
i S� �Ll U ,r]Ise 0 r] \ t
Permit Issued_ _ _ 19 By.
Installation Completed, Inspected and Approved 19 By