HomeMy WebLinkAboutSeptic New 41 Ash Road TOWN OF SOUTH WI N DSOR
al BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Appli tion No.
TO THE BUILDING DEPARTMENT: Date� 19 �
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: /� i_
1. Owner of Propert —_-emu 14 l ye"70- dress of Owner/ s :
2. Location of Property 4e� Lot. No.
3. Type of Structure ' �-��'� t� t ` No. of Bedrooms_
(Dwelling,CcImmercial.Building,Store,e .)
4. Number of Families or Persons to Occupy Premises_ & r%s
5. Plumbing Fixtures: Water Closets ,. Urinals 'ram' Lavatories thttubs
Showers__ Kitchen Sinks__ Laundry Tubs' Garbage Grinder `' Other,&.4'' d erg a.�htrr
6. Liquid Capacity of Septic Tank
_ 'V f 3 Material of Septic Tank CC3nkm5.-� C.
iL ar � 1 ar' t�4-v1 Maximum round water table 5 �
7. Soil Conditions: Type of Soi g
(Sand,Grakel,Clay,etc19
� 6
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 inn I
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
i
12. Leaching System: Number of trenches e Length Width Total7Y_0_-5
Other
Signatur
Lqz�
0 d2o
(Licensed Installer
(Sketch showing all minimum distances and other details required below)
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mA_Issued__ r- 44
Installan omp eted; Irispectd'and ilpproved� 19 By •