HomeMy WebLinkAbout1964-3-26 - 189 Miller Road - Septic As BuiltTOWN OF SOUTH WINDSOR
BU i LD‘ING DEPARTMENT
South Windsor,Connec ticut
Application for Permit to Install or Repair Individual Sewage Disposal Sysiem
Application No.We?
TO THE BUILDING DEPARTMENT:Date ‘2 e’19 6,7
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
Owner of Property g1?Address of Owner W 52w}bév 'M/v
Location of Property I9?'%(/é&«//L¢/Lot.No.
Type of Structure &/m,6zu:4 No.of Bedrooms
6.Liquid Capacity of Septic Tank /"00 //Material of Septic Tank_é¢/a71)
7.Soil Conditions:Type of Soil Maximum ground water table
(Sand,Grav ,Clay,etc.)
8.If not served by public water supply:Distance from Owner’s well
“7
a?5‘,t from adjacent wells
.
é
f_/,.
9.Distance to nearest water course,drainage ditch,storm drain or embankment
10.Percolation Tests:Time for 1"drop in soil test M Classification of soil </
11.Minimum square feet of eEective seepage area requiredh,y&é9 54v ‘/W€J€c/u/
12.Leaching System:Number of trenches i Length 5 tie ./w Width 3a /"Total r932;4
<~-t an,a
Other
(Licensed sta l
I?
Signature 4
s
(Sketch showing all mini-mum distances and other details red below)
Permit Issued,19 By
Installation Completed,Inspected and Approved 19 By
r ‘I
(Dwelling,mercial Building,Store,etc.)
Persons to Premises M4.Number of Families or Occupy
5.Plumbing Fixtures:Water Closets 2..Urinals Lavatories 2"Bathtubs /
Showers Kitchen Sinks f Laundry Tubs Garbage Grinder O Other