HomeMy WebLinkAboutSeptic New 815 Avery Street r s
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TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
&1Ie-1-1 n A,�EGvJ�2U 'ram Application No.
TO THE BUILDING DEPARTMENT: Date 6 / 6�
19 ,
A permit is requested for repair or construction of an individual sewage ispl system
o a concerning which the
following information is submitted:
1. Owner of Property-A- Address of Owner 0 001- s
2. Location of Property. Lot. No.
3. Type of Structure No. of Bedrooms 7�
(Dwelliny,fCommercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals / Lavatories ` Bathtubs
Showers Kitchen Sinks Laundry Tu j Garbage Grinder Other _
6. Liquid Capacity of Septic Tank-MOO Material of Septic Tank .r" ��aronlhD�
�
(Sand,Gravel,Clay,etc.)
7. Soil Conditions: Type of Soil ( Maximum ground water table -
8. If not served by public water supply: Distance from Owner's well 0"aaO from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or emban ment
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Total :!�`00
Other
Signatur
(Licensed Installer
(Sketch showing all minimum distances and other details required below:)
Rom-
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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