HomeMy WebLinkAboutSeptic New 788 Avery Street TOWN OF SOUTH WI N DSOR '
BUILDING DEPARTMENT sQ-
South Windsor, Connecticut Y� ± 0 �
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No._ w/z/
TO THE BUILDING DEPARTMENT: Date. ali (T- 19 6
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property Address of Owner—"I fQp
2. Location of Property___��&Lyr- Lot. No.
3. Type of Structure &LL- i No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_0/lf";C- Z! W JL
.sq�-
5. Plumbing Fixtures: Water Closets Urinals Lavatories_ /Boat/httubs_
Showers Kitchen Sinks_ Laundry Tubs Garbage Grinder '�� Other 1(�iftS'1 a&�449 ` '
6. Liquid Capacity of Septic Tank �71r(o✓ _Material of Septic TankO �
7. Soil Conditions: Type of Soil T_ Maximum ground water table
((ss TandT av 1,Clay,etc.
8. If not served by public water supply: Distance from Owner's well from adjacent wells
9. Distance to nearest water course, drainage ditch, st rm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test C Al Classification of soil
—,"2-,Zd V
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches s 1 Lengthll.'W:�: idth Total
Other d
d� d Signature
�� tensed Installer)
(Sketch showing all minimum distances and other details required ow)
3
0
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By