HomeMy WebLinkAboutDrain Layers Permit 146 Pine Knob Drive (2) TOWN OF SOUTH WI N DSOR �►
BUILDING DEPARTMENT op
South Windsor, Connecticut C�c�C-4 6106
Application for Permit to Install or Repair Individual Sewage Disposal System-,O///,,--
Applicatio��n--��No.
TO THE BUILDING DEPARTMENT: Datec�U"' 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: j
1. Owner of Property, v»�'� Address of Owner.���„ y sry y
2. Location of Property e v Lot. No. 3'2,
3. Type of Structure Le e /i roc; No. of Bedroomsy
Dwelling,Commer ial Building, tore,etc
4. Number of Families or Persons to Occupy Premisgs'_' SOKs
5. Plumbing Fixtures: Water Closets Urinals Lavatories _ Bathtubs_
Showers__ Kitchen Sinks_ Laundry Tubs .-� ' . Garbage'Grinder Other Co V-y&SL
6. Liquid Capacity of Septic Tan JCS tom@ 2 Material of Septic Tank x+ w<. C.
?. Soil Conditions: Type of Soil0—!au Maximum ground water table
(San ,, ravel,C5 ,etc.)
8. If not served by public water supply: - istance from Owner's well from adjacent wells---�-
9. Distance to nearest water course, dra' age ditch, storm drain or embankment__ "�"►
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective spepagq area required
12. Leaching System: Number of trenches _ Length ye3 Width � Total35 C)' '!
Other
Signatur
L�
(Licensed Install
(sketch showing all minimum distances and other details required below)
A.
e ! c; `t,er••w Yi w 41-1
aY lend gY 'rK H�::�
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Permit Issued 19 By
Installation Completed, Inspected and Approved B