HomeMy WebLinkAbout1966-4-14 - 190 Lawrence Road - Septic ApplicationTOWN OF
B U i LD
South
TO THE BUILDING DEPARTMENT:
SOUTH WI N DSOR
ING DEPARTMENT
Windsor,Connec ticut
Applucahon for Permit to Install or Repair lndmdual Sewage Disposal System
Apphcatmn No.
Date if?ui//,i/
4»
19 “I
A permit is requested for repair or construction of an individual sewage dfsposal system concerning which the
following information is submitted:xv
w“1.Owner of Property K
2.Location of Property
3.Type of Structure K
Klo/¢,m,
(Dwelling.Commercral Building,Store etc )
Address of Owner (/K'll Afr ,.
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from Owner’s Well from adjacent well8.If not served by public water supply:Distance
9.Distance to nearest water course,drainage ditch,storm drain or embankment
10.Percolation Tests:Time for 1"drop in soil test
11.Minimum square feet of effective seepage area required
12.Leaching System:Number of trenches
W7?{.7,Classification of soi l
Length Width,Total iv
Installation Completed,Inspected and Approved 19 By
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No.of Bedrooms v
TV//Lot.
No /‘«J a.I
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4.Number of Families or Persons to Occupy Premises t
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5.Plumbing Fixtures:Water Closets [ff Urinals Lavatories 5w“Bathtubs
Showers Kitchen Sinks ’Laundry Tubs Garbage Grinder Other
6.Liquid Capacity of Septic Tank /z é g roe ’/Material of Septic Tank i/(fg/w xx:41-;
7.Soil Conditions:Type of 5011 #45»w 'Maximum ground water table
(Sand Gravel Clay/etc )
Other
Signature é/‘z “(395%
(Licensed Installer]
(Sketch showing all minimum distances and ithevr details required below)
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Permit Issued 19 By
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