HomeMy WebLinkAboutSeptic Repair 230 Brook Street TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
�y awocK /00 South Windsor, Connecticut
Application for Permit to Install o Re air Individual Sewage Disposal System
Application No. Oj//Zlb•/
JO THE BUILDING DEPARTMENT: Date/ d'rM�D�LZT 19
A permit is requested fo epai r construction of an individual sewage disposal system concerning which the
following information is submitted:
• 1. Owner of Property E a; Address of OwnerASOA%toed Sr"drr
2. Location of Property SAAI4r Lot. No.
3. Type of Structure ZW444/44 No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises Al!w V% 0ANII.J/
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks �� Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 45I0ST/ Material of Septic Tank
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7. Soil Conditions: Type of Soil SAND° ' •'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
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Widthi:.a Of'.- Total
Other
Signature
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(Sketch showing all minimum distances and at6 , rt i 'rLe s
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Permit Issued /lf/sklaet!'r 19'70 y
Installation Completed, Inspected and Approved /.- Htvu s;- 19-7D lii
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To help locate your, sewer-connection on the main: line, please show p`
where you would like the connection by drawing a line From the house or
the septic.tank to the ma€n 1€ne in the street. Also, install stake_ in yard
to indicate line a-s shawri orr sketch TF you have •any doubt please contact.r
the Town Engindie'd ngrDepartment.
.: Please draw unportant tnformattcm such as driveways. Large trees
and other-obstructions
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