HomeMy WebLinkAboutSeptic New 812 Avery Street TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT ��
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Applic t' n No.
TO THE BUILDING DEPARTMENT: Date O 3 19
A permit is requested for repair or construction of an individual sewage disposal system concernm which the
following information is s mitted: ./?` /�
1. Owner of Property f e v�vt- A/1"6XAddress of Owner<eofx�Ai?
2. Location of Property d 0,a /T I" 44 Z%' Lot. No.
3. Type of Structure GU L 19 No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_O/I/Ay�—
5. Plumbing Fixtures: Water Closets Urinals Lavatories— Bathtubs
Showers_ Kitchen Sinks` Laundry Tubs Garbage Grinder Other._
6. Liquid Capacity of Septic Tank �2� CY QA-+L.. Material of Septic Tank C4 ,e j9 d/,/0e.1
7. Soil Conditions: Type of Soil n 4AE &"(/ �/��Maximum ground water table �
(Sand,G vel, ay,eta)
8. If not served by public water supply: Distance from Owner's well �from%ajacent wells9. Distance to nearest water course, drainage ditch, sto m rrain or embankment
10. Percolation Tests: Time for 1" drop in soil test C� CAI Classification of soil c
11. Minimum square feet of effective seepage area required tL,S 4,!
12. Leaching System: Number of trenches (� Length Width j— Tota A./;f"
Other
Signature C
(LicensedInstaller)
(Sketch showin minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 9 AkVA5 dLl oEit 19 &4 By
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