HomeMy WebLinkAboutSewer New 545 Avery Street TOWN OF SOUTH WI N DSOR 1912�.e..-",T
BUILDING DEPARTMENT r►Ir✓, 7�-4:
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. 47 7.0 1
TO THE BUILDING DEPARTMENT: Date -1: 7��d< u'a2�J 19 76
A permit is requested for repair or onstructio of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property Address of Owner
2. Location of Property V-,z'it �r/�e=�'T �?c � Ag-1514 r-s J Lot. No. I
3. Type of Structure ��'��l �` No. of Bedrooms 3
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ tM ii ec r) f-Am i«f
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 1,b0cl Material of Septic Tank 0446 24rrF
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 641c_ 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 S monl u'r CS Classification of soil
11. Minimum square feet of effective seepage area required i lSO Pr<C- A-Ar b l2.cc,lrl •TcrijL ct;: :;�` O T-
12. Leaching System: Number of trenches fkaEE 433 Length AQtouS Width i r-CC--r Total Sys S!j FT.
Other
Signature G6 -
(Licensed Install )
(Sketch showing all minimum distances and other deiail5 required below)
rlc 0.= imsr-%"C-4 AT 7,140 ®C-
Permit Issued Q 7 4%AA016!q 19-20 By /yEL C-0,,;A41>5
Installation Completed, Inspected and Approved ®.S- AeCN 1970 B 113cu,4105 A,
TOWN OF SOUTH WINDSOR
TOWN HALL
SOUTH WINDSOR, CONN. 06074
DEPARTMENT POLLUTION CONTROL
65 / �7d
Date . ... . . . . . . . . . . . ... . . . . . . . .
The Sanitary Sewer . . . . . . . . Septic System . . . . . .
at ry . .
or lot #. . . .1 . . . . . . . . has been installed and completed
in accordance with the Town of South Windsor ordinances
and regulations.
Accepted and Approved
F
By Date
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