HomeMy WebLinkAbout1967-8-24 - 1249 John Fitch Boulevard - Septic ApplicationTOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor,Connec tic ut
Application for Permit to Install or®ndividual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT:N Date rP/J v 19 4.7L ‘
A permit is requested forép’air .or'construction of an individual sewage disposal system concerning which thefollowinginformationissubmitted:
7.Soil Conditions:Type of Soil Maximum ground water tabl(Sand,Gravel,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
10.Percolation Tests:Time for 1"drop in soil test Classification of soi l
11.Minimum square feet of effective seepage area required
Permit Issued 19 By
Installation Completed,Inspected and Approved 19 By
e
s
1.Owner of Property V9 ,{f/fa4/f Address of Owner .9?7 ks T c/f ed ,I /)//2.Location of Property AM #N gré i4 5LVb (K4?i4i!/“WU ‘5 J fry-m )Lot.No.
3.Type of Structure \65 /‘//7,é‘%aa K 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
12.Leaching System:Number of trenches Length Width Total
Other (I?g)/0 y/a Ci/z‘gr aw]
Signature -/V(Licensed Installer)/V(Sketch showing all minimum distances and other details required below)