HomeMy WebLinkAboutDrain Layers Permit 22 Spruce Lane (2) C vy
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TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or la air Individual Sewage Disposal System
Application No._Q086 —/
TO THE BUILDING DEPARTMENT: Date '+�JE.orEwtBG/t 19
A permit is requested fo repai or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property glptr rJ14trES Address of Owner ZL L SA2c&24F 4A,-jr
2. Location of Property_ dAi►t Lot. No.
3. Type of Structure e, Gt l f S No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises d04fGl3 il-,AA4 14.V
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks ��++ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank CX15 '1^11 Material of Septic Tank
7. Soil Conditions: Type of Soil 0"UEt Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System Number of trenches Length A&/o a s_ Width a.,T Total VMS"
Other
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Signature a ..
(Lfcens9d Installer)
�� (Sketch showing all minum distances and other details required belo�l— W 2' 3'9812i
f ��� rJ®r-L —Mr.^ ,� �
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�s �o�v2 0� B/iSGMGn►r w♦NOe�cd
Permit Issued 06 By Al. C--dwAALO
Installation Completed, Inspected and Approved_ le`Y`�CM 19_�09 Bj
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