HomeMy WebLinkAboutSeptic New 639 Chapel Road 4
TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. -- 6��
TO THE BUILDING DEPARTMENT: Date Jg— 7 19 4� Y
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 V /1l�A91-1 Address of Owner AW1011V
2. Location of Property I e Lot. No.
3. Type of Structure c��/�i`�@ No. of Bedrooms S7
(Dwelling,CobrAiercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatdries Bathtubs f
Showers Kitchen Sinks� Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 1306 IJ @ . Material of Septic Tank 4f<Yf`C- /7 kyx-j
7. Soil Conditions: Type of Soil . Maximum ground water table to a vc�
(sand,1Yravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well /X-/ 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 :Ei
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches 17 Length f r& Width Total
Other 7" -,��w 4" / 9z ��,e
Signature C �
(Tdberifed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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