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HomeMy WebLinkAboutSeptic Repair 19 Ann Road TOWN OF SOUTH WI N DSOR BUILDING DEPARTMENT � South Windsor, Connecticut ,$A Application for Permit to Install or a air Individual Sewage Disposal System Application No.. 6gt070—V TO THE BUILDING DEPARTMENT: Date 10 Am 1 t 19 76 A permit is requested for a air r construction of an individual sewage disposal system concerning which the following information is submitted: //�� 1. Owner of Property`wp-W LL Pe T®Z�t�fc�'i.�© Address of Owner 19 /",44 POA b 2. Location of Property f-Al-7E Lot. No. 3. Type of Structure . lc"IAIG No. of Bedrooms (Dwelling,Commercial Building,Stor ,etc.) 4. Number of Families or Persons to Occupy Premises_�if€ C f) ��+�is cl 5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other 6. Liquid Capacity of Septic Tank Material of Septic Tank 7. Soil Conditions: Type of Soil Maximum ground water table (Sand,Gravel,Clay,etc.) 8. If not served by public water supply: Distance from Owner's well s4 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 K---k 64 Length/y•s Width 2-*Sr /G T Total 3c,A FT- Other Signature ,,��// ( ce se In er (Sketch showing all minimum distances and ofher detallsrequireftrOWT Permit Issued /����� 19 2& By /4Q ' .44-b d fZ Installation Completed, Inspected and Approved /3 A4Pell- By./ilC--1- 6 WQZ o 94. Y Q Al- y k`.'a Ati N R oA D - --