HomeMy WebLinkAboutSeptic Repair 40 Dart Hill Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit t Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date Q 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submited:
1. Owner of Property �9/�u�- �/�(�� Address of Owner 7'CJ �,4197
2. Location of Property Lot. No. a
3. Type of Structure //V G No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ o J
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
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 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 , § ""D s/--
12. Leaching System: Number of trenches Al Length& Aa iau S Width -2.S� Total y/B
Other �f
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
I
x
Pt
':DAara
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By