HomeMy WebLinkAbout1969-2-18 - 23 Lake Street - Septic ApplicationTOWN OF so'UTH WINDSOR
BUILDI N'G DEPARTMENT
South Windsor,Connecticut
Application for Permit to Install or Repair lndividual Sewage Disposal System
TO THE BUILDING DEPARTMENT:
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1.Owner of Propertyégéx/A,grm/Vf
2.Location of Property
3.Type of Structure Ӣ5M/{1;n14
Address of Owner#za’
(Dwelling,CorEmercial Building,Store.etc.)
4.Number of Families or Persons to Occupy Premises /
5.Plumbing Fixtures:Water Closets Urinals
Showers z Kitchen Sinks 4 Laundry Tubs
6.Liquid Capacity of Septic Tank Material of Septic Tank,
7.Soil Conditions:Type of Soil
8.If not served by public water supply:Distance from Owner’s well ,&”W from adjacent wells
9.Distance to nearest water course,drainage ditch,storm drain or embankment
10.Percolation Tests:Time for 1”drop in soil test Classification of soil i
11.Minimum square feet of effective seepage area required
12.Leaching System:Number of trenches Length /47 xix/f;Width 3?Total
Other
q
h;Lavatories
Garbage Grinder
(Sand,Gravel,Clay,etc.)
Lot.No.‘2,
No.of Bedrooms i
g;Bathtubs é
Other
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(Sketch showing all minimum distances and other details required below)
Permit Issued,19
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Installation Completed,Inspected and Approved 19 By
Application No.
Date,zaé.,/.<,?19 5?
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