HomeMy WebLinkAbout1965-5-28 - 21 Laurel Street - Septic ApplicationTOWN OF SOUTH WINDSOR CMW"yew
BUILDING DEPARTMENT ”A %7000SouthWindsor,Connecticut
Application for Permit to Install or Repair lndividual Sewage Disposal System a;
Application No.5‘~2 fré f
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.Owner of Property yv/M “awhw Address of Owner iz /
2.Location of Property i 511/r /gig/if «V ¢Lot.No.46'/
3.Type of Structure ,d’v W No.of Bedrooms J,
()Dwelling,Commercial Building,Store,etc.)
4.Number of Families or Persons to Occupy Premises
5.Plumbing Fixtures:Water Closets Urinals Lavatories /Bathtubs l
Showers /Kitchen Sinks /éwry Tubs Garbage Grinder )Other.
6.Liquid Capacity of Septic Tank a ,/Material of Septic Ta
7.Soil Conditions:Type of Soil /I4 /‘7 Maximum ground water tab
(Sand,Grave}/,Clay,etc.)
8.If not served by public water supply:Distance from Owner’s well H E g]from adjacent wells iJ)
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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 i
11.Minimum square feet of effective seepage area required
Permit Issued 1 9 By
Installation Completed,Inspected and Approved 19 By
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n I j .
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12.Leaching System:Number of trenches Length Width Total
Other it.”1 7
Signature (Licensed Iryaller)
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