HomeMy WebLinkAbout1964-10-5 - 220 Laurel Street - Septic Application\Ila)
TOWN ‘OF SOUTH WI N DSOR M
BU I LD‘ING DEPARTMENT
South Windsor,Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System“
x3;Application No.
To THE BUILDING DEPARTMENT:Date /3 .g.19 6%/
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is subm
1.Owner of Property Address of Owner 2 g a
2.Location of Property ~Lot No SL
3.Type of Structure f .54 No.of Bedrooms 3
(Dwe ng,Commercial Building,Store etc )
9.Distance to nearest water course,drainage ditch,storm drain or embankment
10.Percolation Tests:Time for 1"drop in soil test Classidcation of soi l
l1.Minimum square feet of effective seepage area required
12.Leaching System:Number of trenches 3 Length /9 i
Width £2 I
Total ’kJO.,
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Installation Completed,Inspected and Approved as’égijgJZq/LJ 19 9y By
4.Number of Families or Persons to Occupy Premises a
5.Plumbing Fixtures:Water Closets k Urinals 4r Lavatories ¢-Bathtubs ¢
Showers %Kitchen Sinks yr Laundry Tubs &Garbage Grinder Other ;I /’
6.Liquid Capacity of Septic Tank '$7 7 \Material of Septic Tank
f
7.
8.
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 M from adjacent
f /..-7
wells
Other 1"///
%’//Signature (Licensed Installer)N(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By