HomeMy WebLinkAbout1970-6-3 - 1076 Main Street - Septic ApplicationK‘é glb TOWN OF SOUTH WINDSOR 6‘4#17-
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N-G DEPARTMENT
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Application for Permit to W Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT:Date 19 2Q
A permit is requested for repair or construction of an individual sewage disposal system concerning which thefollowinginformationissubmitted:
ddress of Owner 4A
2.Location of Propert y
3.Type of Structure No.of Bedrooms(Dwelling,Commercial Building,Store,etc.)I
v
Lot.No.
I
1.Owner of Propert y
4.Number of Families or Persons to Occupy Premises
5.Plumbing Fixtures:Water Closets Urinals La tories j-Bathtubs ;
Showers Q Kitchen Sinks l Laundry Tubs l Garbage Grinder d Other /
6.Liquid Capacity of Septic Tank /b Material of Septic Tank C‘a W OI‘¢+c
I7.Soil Conditions:Type of Soil Maximum ground water table ’
I
8.If not served by public water supply:Distance from Owner’s well from adjacent wells dEa?I
(and,avel,Clay,etc.)
9.Distance to nearest water course,drainage ditch,storm drain or embankment +/a 0 bI
10.Percolation Tests:Time for 1”(grep iiiin soil test Classification of soil
11.Minimum square feet of effective seepage area required
12.Leaching System:Number of trenches Length Widt Totalh
Other
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Signatur e
e$e Ins er «’9.a 5-917;)(Sketch showing all minimum distances and o er detal‘s reh‘u‘i’r’ed‘xed'olvf)
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Permit Issued a3 JumS 19 7o By Ina.gbwacp§HJK
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Installation Completed,Inspected and Approved G3 JING'19 1a Byj’7a Egummuz J4 ,I
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