HomeMy WebLinkAboutSeptic Repair 340 Benedict Drive 4c .p... TOWN OF SOUTH WINDSOR pEAo",f
6%1 f3= BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or epair Individual Sewage Disposal System
Application No. AW 9743—Z
TO THE BUILDING DEPARTMENT: Date_ /9 A#V 19-740
A permit is requested for air r construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property &!tM 1.4/rT4W0i Address of Owner $'1/40 rQawOopeT :Vt/VF
2. Location of Property XA^C Lot. No. /!o
3. Type of Structure No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises E �/� 04100&Y
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank - Qos✓CZFr
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 Aa13LIf�'. 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.,ot soil
11.- Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches -Two. 62 Length i,3 o rc r Width 2.S FT Total 3a S �` F-r.
Other Lus d FIEA.D
Signature
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(Licensed Installer /k..m R. SftV4SrER
(Sketch showing all minimum distances and other details required below) Sol%. siano)
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Permit Issued 19240 By /yluV/M E �r Jam.
Installation Completed, Inspected and Approved Ar 19Z By/tIFiLV/N AFOVIA&A Tit
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