HomeMy WebLinkAboutSeptic Repair 48 Davewell Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Ier Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date_ Uh a�(S 19 40 7
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 td 4 �'? �" � Address of Owner t. �•$ t�,,�/ ��
2. Location of Property 4 r.P+z Lot. No.�_
3. Type of Structure uie ll a �m Dwelling,Commercial Building,Store,etc.) No. of Bedrooms
4. Number of Families or Persons to Occupy Premises_ E1►,i Ag
5. Plumbing Fixtures: Water Closets Urinals_ Lavatories Bathtubs_
Showers Kitchen Sinks_ Laundry Tubs_ Garbage Grinder____S3TTOther 40
p
6. Liquid Capacity of Septic Tank � D D Material of Septic Tank / �l
A
7. Soil Conditions: Type of Soil %Y4 &D Maximum ground water table
end, ravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well from adjacent wells
i
9. Distance to nearest water course, drainage ditch, storm drain or embankment 'L C& Q Q
10. Percolation Tests: Time for 1" drop in soil test J,ArL —Classification of soil
11. Minimum square feet of effective seepage area required 71_�
12. Leaching System: Number of trenches Length Width ,Id / Total ,3d X/,&
Other f�
Signature
(Licensed installer)
)
(Sketch showing all minimum distanc and other details required below)
I / 1 Assna.pTim 3sb
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SILO IrIa. T.J�c
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Permit Issued 2® -c141< 19_!�bT By 4bW,41LO3 X2
Installation Completed, Inspected and Approved 19 By