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HomeMy WebLinkAboutSeptic New 81 Chapel Road h TOWN OF SOUTH WI N DSOR BUILDING DEPARTMENT South Windsor, Connecticut Application for Permit to Install or Repair Individual Sewage Disposal System�/ Application No.-- � TO THE BUILDING DEPARTMENT: Date t,`.�a 19 , A permit is requested for repair or construction of an individual sewage disposal system concerning which the following information is submitted: 1. Owner of Propert ► a\,. • L0 Address of Owner 2. Location of Property f -a Lot. No. 3. Type of Structure c No. of Bedrooms_ 73 (Dwelling,commercial Building,Store,etc.) 4. Number of Families or Persons to Occupy Premises_ 5. Plumbing Fixtures: Water Closets ;tl Urinals Lavatories__ Bathtubs_ Showers_ Kitchen Sinks L_ Laundry Tubs_ Garbage Grinder Other 6. Liquid Capacity of Septic Tank /'o C- Material of Septic Tank CC, yr e, i /C- s 7. Soil Conditions: Type of Soil et H Maximum ground water table it (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 Width Total Other r Signature Licensed stalld (Sketch showing all minimum distances and other details required below) \NW 3.2i 3� r � r r ' r r � r r 4 t r r � s!o, 4, ,t a Permit Issued 19 By Installation Completed, Inspected and Approved 19j&— By f i N/F LUC.Y/a.9 _ Q M•S. M•5. Q 90*y6 ' S��q7 9Z © Q Q Wn 3oS`•�c. NO Z, 88 99• o .�• v /Y/F tTU/PG�'�AS CIF - Tf46-oI0ORIE 49 P/ T.' O &O V s " �OAE --A'3 � SU gs-TA�T/A.0 Ly �•'P�PECJ."e- y�Lnt,ar%a�z.�..