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HomeMy WebLinkAboutSeptic New 90 Beelzebub 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. -o TO THE BUILDING DEPARTMENT: Date. %i9iP aZ3, 19 G A permit is requested for repair or construction of an individual sewage disposal system concerning which the following information is submitted: _l 1. Owner of Property G/ Address of Owner.__ �U '� � Z� �� �Cl 2. Location of Property Lot. No. 3. Type of Structure (D No. of Bedrooms_ welling,Commercial Building,Store,etc.) 4. Number of Families or Persons to Occupy Premises_ 5. Plumbing Fixtures: Water Closets Urinals Lavatories / Bathtubs_ Showers Kitchen Sinks Laundry Tubs '— Garbage Grinder_ Othe 6. Liquid Capacity of Septic Tank n Material eptic Tank ld 7. Soil Conditions: Type of Soil Maximum ground water table (Sand,Gravel,Clay,et 8. If not served by public water supply: Distance from Owner's well C from adjacent wells 9. Distance to nearest water course, drainage ditch, storm drain or emban merit 10. Percolation Tests: Time for 1" drop in soil test Classification of soil 11. Minimum square feet of effective seepage area required GQ 12. Leaching stem: Number of tren es x Leng Width,, Total " Other cAlle Signature L c I(Iftensed Installer) (Sketch showing all minimum distances and other details required below) Permit Issued 19 By Installation Completed, Inspected and Approved 19 By owmeeo NA mE: S A/l7ES' .ZNS7-A 6R _ �rLLi�S+rh c LZ DlSi Awc, ; 1You.SG -fo ' ANk &JAP-Pm OR T-RF-,,VCN Z L~ ror,4L of or`YF4D 8� 7b rALL S4 i=r A1?t,� 2-4s` E��s O u T i .- �_ It9tl�VdQ A NDJ r Cy b 4 CL� 7y 34�3" 7Anr K, v Dv /Icva6 � � '� ° A► 6� �' i✓t1T� : /N�.�T S'�o6 mT ARy W O� o , S��Tic TA.t)K � rt rC646-X1 ) / TOWN OF SOUTH WINDSOR A1 C� BUILDING DEPARTMENT A4lx,-4rr i&57L l South Windsor, Connecticut �v. ?v �� t" I��or Permit to Install or Repair Individual Sewage Disposal System �P P 9 P Y q—() Application No. TO THE BUILDING DEPARTMENT: Date--t rrt1 Gk- I. -19-!22 A permit is requested for repair or a nstruction of an individual sewage disposal system concerning which the following information is submitted: 1. Owner of Property Address of Owner Q 2. Location of Property Lot. No/3 i YyeF l 3. Type of Structure t/l.�l/ ram L— l 6 No. of Bedrooms_ -Y (Dwelling,Commercial Building,Store,etc.) (� 4. Number of Families or Persons to Occupy Premises_0&& IL l 5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other 6. Liquid Capacity of Septic Tank I Material of Septic Tank 7. Soil Conditions: Type of Soil L- Maximum ground water table (Band,.GfavPl,-Crff7,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 drfLin embankments-f „ i� 10. Percolation Tests: Time for 1" drop in soil test IE F Classification of soil 11. Minimum square feet of effective seepage area required ,�4­ 12. Leachin ystem: Number of renches Length Width Total Other rc c- �/U (—"`,���� Signature (Licensed Installer) (Sketch showing all minimum distances and other details required below) AaW.-W tLrC#�A) Ir f(C w F Permit Issued o/ 19 7© Installation Completed, Inspected and Approved a/ fiou-SE !`�2t�Lc,Q i9�2EA � alv hClTekl�N slnit< !O-Poor WR s-4E,2 SY.Tr" 14 l RM x�o pasr,444 cD' /o/a170 UEFA J' ,e y 0 e s-XIAOVOy, 'r- 8—F-ocor DIRM of& ae4nA