HomeMy WebLinkAbout1964-4-2 - 146 Kelly Road - Septic ApplicationTOWN OF SOUTH WINDSOR
BU l LDI NG DEPARTMENT
South Windsor,Connecticu t
1 ~"""Application for Permit to lnstoll or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT:Date 6//E.2:19 g;g '
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1.Owner of Property p 4%i MAk Aaé!’iii Address of Owner /Vé /f2;//4;‘cf gi'P/u/
2.Location of Property \f/wi 1 A?Lot.No.
3.Type of Structure D w EMW s No.of Bedroom
(Ewelling,Commercial Building,Store,etc.)
4.Number of Families or Persons to Occupy Premises
5.Plumbing Fixtures:Water Closets Urinals Lavatories Z Bathtubs Z
Showers Z Kitchen Sinks z Laundry Tubs /Garbage Grinder Other
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7.Soil Conditions:Type of Soil Maximum ground water table V6 4/.f
(Sand,Gravel,Clay,etc.)
8.If not served by public water supply:Distance from Owner’s well from adjacent wells 7
9.Distance to nearest water course,drainage ditch,storm drain or embankment Azv—r mag“
10.Percolation Tests:Time for 1”drop in soil test Classincation of soil "3 t It r A~I
11.Minimum square feet of effective seepage area required
12,Leaching System:Number of trenches .3?Length 5;
‘0 Width a l5“g Total or:,4../
Other
"J l a?k6.Liquid Capacity of Septic Tan Material of Septic Tank CTP"
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Signature \v,g«{’;gw ~V q,‘%;f:rl
(Licensed Installer)g I
(Sketch showing all minimum distances and other details required below)
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,N \X r t ?¢Permit Issued "5 19 .f/r'_
Installation Completed,Inspected and Approved 19 By