HomeMy WebLinkAboutdrain layer permit 65 Mascolo Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System F�g
Application No.
TO THE BUILDING DEPARTMENT: Date. ,L�2-?� 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
/17
1. Owner of Property /�/ a Address of er � S
2. Location of Property /dl�z�-9� �� Lot. No.
3. Type of Structure / �f No. of Bedrooms
(Dwelling,Com ercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Z Bathtubs
Showers Kitchen Sinks_____ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank C5 Material of Septic Tank c -,
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7. Soil Conditions: Type of Soil i Maximum ground water table Po wA7Pi2® 8 Feet-
(Sand,Gravel,Clay,etc.) o W
8. If not served by public water supply: Distance from Owner's well from adjacent wells
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9. Distance to nearest water course, drainage ditch, storm drain or embankment Go 1 o Sle Q&i D2 A I A)
10. Percolation Tests: Time for 1" drop in soil test 1 1/7-- 67/AlClassification of soil 5—"'LASE
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Total �.
Other E P A 6 F 9 LcAC,4 (5--S.S Poo
Signature V1
(11 ensed Installer)
(Sketch showing all minimum distances and other details required below)
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el_IsAN alZAVEL 16)rMDO VOW Q
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By