HomeMy WebLinkAbout1964 - 1179 John Fitch Boulevard - Septic ApplicationTOWN OF SOUTH WINDSOR
BU I LDI NG DEPARTMENT
South Windsor,Co nnecticut
Appiication for Permit to Install or Repair Individual Sewage Disposal System
Application No.#yyéa
TO THE BUILDING DEPARTMENT:Date g:/S3 X/19 /’3 5
A permit is requested for repair or construction of an individual sewage disgsal system
tconcerning
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followrng information is submltted
1.
2.
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Owner of PrOperty s!AM/Cl’v 77Mw V//1”l 5}”i WW/Vg’JW
Location of PropertyT//9 0%,»G \6 ’H ot.No.
TYDe of Structure ///5 ‘/“#7 3/I 5 L No.of Bedroom
(Dwemaé,Commercial Building,Store.etc.)
4.Number of Families or Persons to Occupy Premises
5.Plumbing Fixtures:Water Closets :2’Urinals Lavatories :42 Bathtub
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
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7.Soil Conditions:Type of Soil Maximum ground water table
c j,»-l é
(Sand,G avel,Clay,etc.)
8.If not served by public water supply:Distance from Owner’s well from adjacent well
9.Distance to nearest water course,drainage ditch,storm drain or embankment
7"”“d—Classification of soil
11.Minimum square feet of edective seepage area required genre—J
/-Material of Septic Tank 4%,{Wi I?6.Liquid Capacity or Septic Tank /[(‘i‘
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12.Leaching System:Number of trenches w—5 Length {D 7 ’w Width Q TOtal ’Li g x§’\g f
Other
10.Percolation Tests:Time for 1"drop in soil tes t
Signature ficense/dflstaller
(Sketch showmg all minimum distances and other details required below)
Permit Issued 1 9 By
Installation Completed,Inspected and Approved 19 By
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