HomeMy WebLinkAbout1968-5 - 105 Greenfield Drive - Septic ApplicationTOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor,Connecticu t
Application for Permit to Install or Repair Individual Sewage Disposal System
épplication No.
TO THE BUILDING DEPARTMENT:Date 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which thefollowinginformationissm1ted:
Owner of Property Address of Owner é y/Mc®4v AZ.
Locatlon of Property ogz Lg‘dtw Lot.No.//@Mém 3TypeofStructureNo.of Bedroomsuilding,Store,etc.)(Dwellmg,Commercr
a4.Number of Families or Persons to Occupy Premises I
5.Plumbing Fixtures:Water Closets Urinals C?Lavatories £’Bathtubs /
Showers Z Kitchen Sinks /Laundry Tubs Garbage Grinder A Other
6.Liquid Capacity of Septic Tank Material of Septic Tank (
-7.Sell Conditions:Type of S011 (L Maxnnum ground water table-(Sand,Grave ,ay,etc )
8.If not served by public water supply:Distance from Owner’s well from adjacent well s
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 3 Length [57 ¢T Width 2.5 FT Tota 953;;~r
Installation Completed,Inspected and Approved 19 By
Other
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Signature .y ;I gd-dj’éa(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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