HomeMy WebLinkAboutSeptic New 9 Brewster Road Q TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT ���`f"T
y A Def2- South Windsor, Connecticut 4 o, 76 yy
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. 611,Z9?n—/
TO THE BUILDING DEPARTMENT: Date M-�9-u,J, 19_7 0_
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 in ES/7)1,WiE7 Address of Owner
2. Location of Property Lot. No. R/l/
3. Type of Structure -1�wrt,-1^1 No. of Bedrooms �
7 (Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises L5,gg- L O
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tanker Qeo de"Lipw!s Material of Septic Tank cOMC/ ffre
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 P&LAIA A 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 /.V Aizwu.,C S Classification of soil
11. Minimum square feet of effective seepage area required190 s!g F:r A*%z /3Erllzoes�7 TT. V �
eq +� n70 s� F�
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12. Leaching System: Number of trenches O%A C401 Length. 8V PT. Width �2.S- F i Total4TS Or,
Other
Signature
/(Licensed Install r)
(Sketdh showing all minimum distances and at' de s�requi ow)r��' 3 ��Gs,
S" N "rPC140% P�, mT PA-AW F•A-
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at Sys-ram d. k+ Ao C+s, be..rtA 140
As I^%►AK rep
Permit Issued A 9 -Z&4 f 19 -20 B
Installation Completed, Inspected and Approved Al ;JLLL%Ll� 1970 wrya
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