HomeMy WebLinkAbout1964-11-4 - 11 Mountain View Road - Kitchen Sink Tank As Built1A/a A ,TOWN OF SOUTH WINDSOR
BU i LDING DEPARTMENT,i
South Windsor,Connecticut
AppIEcation for Permit to Install or Repair Individual Sewage Disposal System
Apphcatmn No
TO THE BUILDING DEPARTMENT“Date Jl/U l/4*19 ML
A permlt 1s requested for repair or constructlon of an 1nd1v1dua1 sewage dlsposal system concernlng Whlch the
followmg mformatlon 1s submltted
Owner of Property LPWI/(l (ll7Lfi g/{Address of Owner,f/l’l WU /l/Tf
Location of Property Sv&'f7?F Lot.No.
Type of SjW’«.No:of Bedrooms
f a 'e s4.Num r o F s or Persons to Occupy Premlse
(Dwelling,Commercial Building,Store,etc.)
/
o ets
Kltch nk
p acity of Septlc Tank
7.Soil Conditions:Type of Soil
(Sand Gr vel Clay etc.
8.If not served by pubhcKWQter supply Dls nce from O ner s w l l
N
9.Dlstance to nearest water coursemdramage dltch storm dram or embankment /
W T«MN W'“Wm u.l10.Percolation Tests:Time for 1”drop 1n 5011 test Clas511ication of soi
11.Minimum square feet of effective seepage area required
12.Leaching System:Number of trenche s
Other /J a!.....
Lengt h
Signature r ’/,V
Licensed Inst ler’()
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed,Inspected and Approved 19 By
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