HomeMy WebLinkAboutSeptic New 64 Barber Hill Road f
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. 11
TO THE BUILDING DEPARTMENT: Date X)Oo719 tl"
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.
2. Location of Property_( ' /Y (� G' � Lot. No. 03
3. Type of Structure No. of Bedrooms
(Dwelling,CqMmercial Building,Store,etc
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatorie Bathtubs
Showers / Kitchen Sinks I Laundry Tubs I Garbage Grinder 0 Other
6. Liquid Capacity of,Septic Tank D D O Material of Septic Tank
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7. Soil Conditions: Type of Soil .-A� Maximum ground water table
(sand,Gravel,Clay,etc.) f / I
8. If not served by public water supply: Distance from Owner's well -7,S from adjacent wells /-/`S
9. Distance to nearest water course, drainage ditch, storm drain or embankment
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10. Percolation Tests: Time for,1" drop in soil test / — %3 Classification of soil An�
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11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length G Width_, C� Total
Other
Signature
(Lice sedIns e
(Sketch showing all minimum distances and other details r ui below)
Permit Issued 3- 19 By
Installation Completed, Inspected and Approved 19 By
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GATION FOR SEWAGE DISPOSAL SVSTEM
OWNER s4 LOCATION 13 tl i I I .11/w^ if �uy
PERCOLATION TESTS: (Record all tests) SOIL MOISTURE:DATE (high, med, low, etc)
TEST READINGS
HOLE#1 HOLE#2 HOLE#3 HOLE#4
Time
Readine Time Reading Time Rendin Time
Reading
I,
TABULATION OF TEST RESULTS
Hole Location Depth Presoak Minimum Percolation Rate
inches ;�_ inr./Inch
1.
2.
3.
4. --
OBSERVATION PITS: (Record all pits)2 Ground Water Table: -
(Date) (Near�BrJow��) r-
qq4
SOIL DESCRIPTIONS
PTTok Jr PTT B` '6 PIT Ot 7 PIT D ff
p 'Ile
l2 2 6
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INVESTIGATION FOR SEWAGE DISPOSAL SYSTEM
OWNER /'v,�, F. o r.G r l��� LOCATION
PERCOLATION TESTS: (Record ail tests) 9 SOIL MOISTURE: L L�
DATE (high, med, low, etc)
TEST READINGS
HOLE #1 HOLE #2 HOLE #3 HOLE #4
Time J Reading Time Reading Time Reading Time Reading
TABULATION OF TEST RESULTS
Hole Location Depth Presoak Minimum Percolation Rate
inches (Ars.) ins./Inch
1.
2.
3.
4.
OBSERVATION PITS: (Record all pits) 2- Ground Water Table:
(Date) (Near M ,Below Max)
U
SOIL DESCRIPTIONS
PIT y PIT$ 7 PIT(Z 3 PIT
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