HomeMy WebLinkAboutSeptic Repair 385 Avery Street eb' TOWN OF SOUTH WI N DSOR
♦�/ BUILDING DEPARTMENT
South Windsor, Connecticut
plication for Permit to Install or Repair Individual Sewage Disposal System
Application 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 sub ted:
1. Owner of Property Address of Owner
—"Z,-
2. Location of Prop Lot. No.
3. Type of Structure No. of Bedrooms
Dwelling,Commercial Building,Store,etc.) V
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Z _ Urinals _ Lavatories / Bathtubs
Showers Kitchen Sinks_ Z Laundry Tubs Garbage Grinder_ Other a
6. Liquid Capacity of Septic Tank e� o1/�/ � Material of Septic Tank
7. Soil Conditions: Type of Soil eiefov/ Maximum ground water table_ D
(Sand,Cfavel,Clay,etc.)8. If not served by public water supply: Distance from Owner's well from adjacent wells 4L"�/P y'
9. Distance to nearest water course, drainage ditch, storm drain or embankment 0
10. Percolation Tests: Time for 1" drop in soil test 024it2' Classification of soil
11. Minimum square feet of effective seepage area required /
12. Leaching System: Number of trenches Length Width Total
Other
Signature
icensed Installer)
( etch showing all minimum ,onces and at details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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