HomeMy WebLinkAboutSeptic New 410 Beelzebub Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMEN-T
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
-IV q I
0 Application No._ v /
d --T
TO THE BUILDING DEPARTMENT: Date. 19 co/
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 of?�ni1��Xe5 AAAddress of Owner,
2. Location of Property��Oee%-e OUi I[e1'' Lot. No.
3. Type of Structure No. of Bedrooms_
(Dwellin , ommercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ elyae -
5. Plumbing Fixtures: Water Closets oz Urinals Lavatories o2 Bathtubs
Showers / Kitchen Sinks / Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank /i1�D Material of Septic Tank �Qiy���.P.f oV
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 /0-0
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required 00
12. Leaching System: Number of trenches Length Wi th Total
Other
Signature
(Licensed Installer)
(Sketch showing all minimu� tonces and other details required below)
t �
L �S' %,✓�
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
a►
f��LfJ/Titti.aC�.r /y1�/j,�-. � l►/{,��J r 1g/Cr � �z�-� �---/�'.6
d,�rf�•`".i�U�' �!`��xl� r+'' G-i�`�3�r�e' ��.,��.....�..._.�../`�d S/, ��3L�i� �fj .�. �,�. ._..___�_'__��/__�........._.__�._.v_.�._
Or
i e
� I i
�,yK