HomeMy WebLinkAboutSeptic New 903 Avery Street R
TOWN OF SOUTH WI N DSOR
! BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No._
TO THE BUILDING DEPARTMENT: Date- Au e
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
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1. Owner of Pro erty Address of Owner
2. Location of;Property J d AVER 5/ - Lot. No.
3. Type of Structure tv ELL / A/ L No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ 1V F Ph M 1,L
5. Plumbing Fixtures: Water Closets Urinals ^--- Lavatories Bathtubs
Showers Kitchen Sinks_ Laundry��TubsR�&D Garbage Grinder Other
6. Liquid Capacity of Septic Tank 7�i1 l�s ,Material of Septic Tank #Ft!f=nft ( t&7T,!�
7. Soil Conditions: Type of Soil Maximum ground water table CJ
(Sand,Gravel,Clay,etc.)
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8. If not served by public water supply: Distance from Owner's well 'i7�`1�Tfrom adjacent wells , 0 P7
9. Distance to nearest water course, drainage ditch, storm drain or embankment ky AWE!
10. Percolation Tests: Time for 1" drop in soil test �� / G) V Classification of soil C-(
11. Minimum square feet of effective seepage area required
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12. Leaching System: Number of trenches_ Length F• Width o Total� `'�L�+��J�L
Other Q.F'7-C ?Le)C t- 0-(1�ke C s'PO674 7
PIC- Lam(NDR f OV A- Signature
Q ql"r censed Insta er)
(Sketch showing all minimum distances'and'* er details required below)
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Permit Issued 19 By
Inspected and Approved Insia�lation Completed, p pp 19 By
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