HomeMy WebLinkAboutDrain Layers Permit 0623 Avery Street T
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
Q� South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. _�
TO THE BUILDING DEPARTMENT: Date. <— 19 rl
A permit is requested for repair or construction of an individual sewage disposal system concerning whi the
following information is submitted:
(o2s
i. Owner of Property J Address of Owner� ,
2. Location of Property Lot. No.
3. Type of Structure (Dwell No. of Bedrooms_!
' g,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals G Lavatories_ Bathtubs
Showers_ Kitchen Sinks` Laundry Tubs_ Garbage Grinder_ Other
6. Liquid Capacity of Septic Tank /'tE!C7ZJ--e-77 4 Material of Septic Tank
7. Soil Conditions: Type of Soil (IfienZti / Maximum ground water table
(S d,Gravel,Clay,etc.) r!)
8. If not served by public water supply: Distance from Owner's well_ P from adjacent wells oe
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test Z�►^��-cv Classification of soil_
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches— Length Width Total
Other --t� 2 �t�� t.:
Signature �—tamer)
( icensed Installer)
(Sketch showing all minimum distances and other details required below)
Aa
67'
t�s�
E2t RED
Permit Issued 19 By
Installation Completed, Inspected and Approved A 19-q— By