HomeMy WebLinkAbout1964-7-25 - 124 Long Hill Road - Septic Application€66”d TOWN OF SOUTH WINDSOR
BUILDI NG DEPARTMENT
South Windsor,Connec ticut
Application for Permit to Install or Repair lndividual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT:Date
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1.
2.
No.of Bedrooms 2
4.Number of Families or Persons to Occupy Premises K ggsj’cw’S
5.Plumbing Fixtures:Water Closets I;Urinals /Lavatories /
Showers A Kitchen Sinks i Laundry Tubs Garbage Grinder
6.Liquid Capacity of Septic Tank “5:73,Material of Septic Tank I
7.Soil Conditions:Type or Son Cdv/Maximum ground water tabl
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Owner of Property ¢Ii/6;?)4‘.(i,5 Address of Owner /0<{§/4/yg %,2’
Location of Property ,/.:4/icy/Vol /7/z}:5./-
Type of Structure ML”!viL z A:£_
(Dwelling,Commercial Building,Store,etc.)
Bathtubs 4
*Sand,Gravel,Clay,etc.)
8.If not served by public water supply:Distance from Owner’s well from adjacent well
9.Distance to nearest water course,drainage ditch,storm drain or embankment
l10.Percolation Tests:Time for 1"drop in soil test Classincation of soi
11.Minimum square feet of eEective seepage area required
h12.Leaching System:Number of trenches Length Widt
Other 4%M,ff/‘a/v‘72?//7P:e mam/f 3/(ii/2%?~
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Signature ,f/
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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Permit Issued
Installation Completed,Inspected and Approved IQLS"c/(n z;L/19 é 7'By
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