HomeMy WebLinkAbout1968-1-22 - 19 High Ridge Road - Septic ApplicationTOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor,Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT'Date /ygcl 1%;
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Locatron of Property I,’a Js,»
A perm1t 1s requested for repalr or constructmn of i1 1nd1v1dual sewage dlsposal system concernmg wh1ch the
followmg 1nformat1on 1s submltted
m -AOwnerofProperty‘le.‘Iw-¢W ddress of ner
Lot.N0.J2"
No.of BedroomsDwelling,Commercial Building,Store,etc.)
4.Number of Families or Persons to Occupy Premises
5.Plumbing Fixtures:Water Closets Z"Urinals Lavatories L-Bathtubs 4'
Showers (Kitchen Sinks Laundry Tubs Garbage Grinder Other
Type of Structur e
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6.Liquid Capacity or Septic Tank /c»?
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Material of Septic Tank @7ZW/17 7AZ r‘J
7.Soil Conditions:Type of So'[£1 ,t a 4¢.Maximum ground water tabl(nd,Graver Clay.etc.)
8.If not served by pubhc water supply Distance from Owner s well from adjacent well s
9.Distance to nearest water course dramage dltch storm drain or embankment
10.Percolation Tests:Time for 1"drop in soil test Classification of soil
11.Mmimum square feet of effective seepage area required é /a m
12.Leaching System:Number of trenche s Length a?ab Width :4 L Total gQ R
Installation Completed,Inspected and Approved 19 By
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Other
Signatu %m4%/Kc’/
(Licensed Installer)/K
(Sketch showing all minimum distances and other details required below)
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Permit Issued 1 9 Byii
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