HomeMy WebLinkAbout1965- 239 Lawrence Road - Septic ApplicationTOWN OF SOUTH WINDSOR if
BUILDING DEPARTMENT
South Windsor,Connec ticut
we?Application No.I
Application for Permit to lnstall or Repair Individual Sewage Disposal System
TO THE BUILDING DEPARTMENT:Date AZM!”19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted :K‘~
Owner of Propert y
Location of Property
A ddress of Owner
mxp /%’/,.Lot.No.
Type of Structure vl a;erg/1,2,;.No.of Bedrooms
4.Number of Families or Persons to Occupy Premises
(Dwelling,Commer i“Building,Store,etc.)
5.Plumbing Fixtures:Water Closets Urinal
Showers /Kitchen Sinks —_L Laundry Tubs /Garbage Grinder Other
6.Liquid Capacity of Septic Tank {2 62>z M Materia1 of Septic Tank Kim/{7 S’%%€(&:g/’
7.Soil Conditions:Type of Soil ;%w/z %é2;z Maximum ground water tabl
-(Sand,Gravel,Clay,etc.)
8.If not served by public water supply:Distance from Owner’s well 75"from adjacent wells ye?/"
9.Distance to nearest water course,drainage ditch,storm drain or embankment
l10.Percolation Tests:Time for 1"drop in soil test Classification of soi
11.Minimum square feet of effective seepage area required
12.Leaching System:Number of trenches Length 3 yr:I Width Z /’z/,l Total yf?3:7
Other \
Signature ,if a i
,(ie sed Installe )
(Sketch showing all minimum distances and other details required below)
Permit Issued !1 9;
Installation Completed,Inspected and Approved
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