HomeMy WebLinkAboutSeptic New 90 Ayers Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut 0,000
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No._
TO THE BUILDING DEPARTMENT: Date 0 l r 9 76 � 19
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 DO 1'0 t()) '`7 L/ 9({-l U 7 G Address of Owner_
2. Location of Property q�,LS ��CJA/�9 G�A�P���/� �ONI�/. Lot. No. f Z
3. Type of Structure �h b C l u C'/// /J No. of Bedrooms 13
(Dwelling,cc cial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises__2 ,, d U
5. Plumbing Fixtures: Water Closets 2 Urinals Lavatories Z Bathtubs
Showers / Kitchen Sinks 2 Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank U C7 CD Material of Septic Tank co /t/C-, 0.2,eo J
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 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 Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Total
Other (- 3/-z s?"J GJ /, 0, Do (a,q 7 7i4&,,c-
Signatu
(Li sed Installer)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved S�/'TEM�,c2 19 By