HomeMy WebLinkAbout1967-5-2 - 177 Laurel Street - Septic ApplicationTOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor,C onnecticut 3&1
Applicahon for Permit to lnstall or Repair lndmdual Sewage Dlsposal System_;6/jj\#
Application No.
TO THE BUILDING DEPARTMENT:Date [)a A v1 F3 19 ~
A permit is requested for repair or construction of an individual sewage dispos l system concerning which t%e
Owner of Property #eoZnc»«"g A30 /u m c}Address of Owner /7 7 1A1 3y c./g—lL
Locatlon of Property I f7 7 L?;'rv c-I <e+Lot.No.S4-
Type of Structure *r Dwt Hi’mq No.of Bedrooms e 3((Dwelling,Commercial BuildHg,Store,etc.)
followmg mformatxon 15 submitted
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Number of Families or Persons to Occupy Premises a pex/SCwmg
Plumbing Fixtures:Water Closets Urinals r-——’I Lavatories I Bathtubslz‘
Showers Z Kitchen Sinks Z Laundry Tubs f Garbage Grlnder ”‘J Other/wugu m},L (
aterial of Septic Tank (‘am gYrg-ée/
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Liquid Capacity of Septic Tan k
Soil Conditions:Type of So i
If not served by public water supply:Distance from Owner’s well W from adjacent well
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10.Percolation Tests:Time for 1”drop in soil test Classification of soi l
Distance to nearest water course,drainage ditch,storm drain or embankment
11.Minimum square feet of effective seepage area required
Leaching System:Number of trenches Length Width Tota1300 z:
ther 5:{)Yz‘C are Qeh¢va‘l’i c (Jere:LL!g )2S
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Signatu r (Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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Permit Issued j
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