HomeMy WebLinkAbout1965-6-9 - 230 Kelly Road - Septic ApplicationTOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor,Connec ticut
Application for Permit to Install or Repair Individual Sewage Disposal System
/.,1 94"
TO THE BUILDING DEPARTMENT:Date 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1.
2.
Type of Structure No.of Bedrooms
(Dwelling,Commercial Building,Store.etc.)
Application No.,
Owner of Property Address of Ownerztw:
Location of Property r Lot.No .i 2w
Number of Families or Persons to Occupy Premises
Urinals 'Lavatories BathtubsPlumbingFixtures:Water Closets
Showers Kitchen Sinks Laundry Tubs Garbage Grinder I Other
Liquid Capacity of Septic Tank Material of Septic Tank
Soil Conditions:Type of Soil Maximum ground water table
(Sand,Gravel,Clay,etc.)
If not served by public water supply:Distance from Owner’s well from adjacent wells
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 eEective seepage area required
12.Leaching System:Number of trenches Length Width Tota
Other
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed,Inspected and Approved 19 By
l