HomeMy WebLinkAbout1969-4-21 - 189 Laurel Street - Septic ApplicationTOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor,Connec ticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Apphcanon No
Date (7&wf 3 /[1‘7ToTHEBUILDINGDEPARTMENT:19
A permit is requested for repair or construction of an individual sewage disposal system concerning which thefollowmg1nformat10nissubmitted
1.Owner of Property J
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/xxx/«C o »VA Address of Owner /?,;/we ¢?./VLf/l—/_€
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2.Location of Property WM/«i m Lot.No.3-2
Permit Issued 19 By
Installation Completed,Inspected and Approved 19 By
4/A
3.Type of Structure Vfé k“No.of Bedrooms >3)
/(Dwe11ing,Commercial Building,Store.etc.)
4.Number of Families or Eersons to Occupy Premises g,
5.Plumbing Fixtures:Water Closets Urinals Lavatories I Bathtubs l
Showers l Kitchen Sinks /Laundry Tubs OtheraGarbageGrinder
6.Liquid Capacity of Septic Tank 1/7?/’///Material of Septic Tank ,Z/gr/
7.
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Soil Conditions:Type of Soil («J/I‘i’ie<///Maximum ground water table ,r
(Sand,Gravel,Clay,etc.)
8.If not served by public water supply:Distance from Owner’s well 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
11.Minimum square feet of eEective seepage area required
12.Leaching System Number of trenches ~’/Length i 6.g i Width I)’Total jé 5244:
Other ,/%/’{/c Ma ”“i/J A&/4 /i ///
Signature/y /f at:1M-{/
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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