HomeMy WebLinkAbout1968-8-29 - 16 Greenfield Drive - Septic ApplicationOWN 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 o� 1. 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is 4sumitted; I
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1. Owner of Property Address of Owner Imet"a 2
2. Location of Property oz S.rfea-1 ,E,� t�� _ Lot. No.
3. Type of Structure _ _ _ ----No. of Bedrooms
4. Number of Families or Persons to Occupy Premises
5. Plumbing Fixtures: Water Closets C>2— Urinals O Lavatories c12— Bathtubs
Showers_ _1 Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic TankG Material of Septic Tian k
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand, ravel, 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
12. Leaching System: Number of trenches. ¢_ _ Length So FT Width Z, s Total3 %ST -
offier
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Signature --- , , !t]
(Sketch showing all minimum distances and other details required below)
Permit
By -
Installation Completed, Inspected and Approved _ 19 By
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GAS:
CONDITION:
S EWER :
REMARKS:
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