HomeMy WebLinkAboutSeptic Repair 107 Dart Hill Road a
TOWN OF SOUTH WI N DSOR rzle- )C,2"1'4
BUILDING DEPARTMENT ' ZD •
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date
A permit is requested for rep lr or construction of an individual sewage disposal system concerning which the
following information is submitted: t es'
1. Owner of Property 422. Address of Owner- /✓'�c �`
2. Location of Property Cam' Lot. No. .0et 39
3. Type of Structure No. of Bedrooms— �.
Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
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,Gr el,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 'Jr Total
Other
Signature
M censedInstaller)
(Sketch showing all minimum distances and her details required below
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�JR.e T ALY %[ 0
Permit Issued 19 By
Installation Completed, Inspected and Approved 44 19 1*,� By