HomeMy WebLinkAboutSeptic New 415 Deming Street TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date 19�
A permit is requested for repair or construction of an individual sewage disp sal system concerning which the
following information is submitted:
1. Owner of Property ram,r �u�y'lj c e Cr\ Address of OwnerTQ Ca
/✓�
2. Location of Property Lot. No.
3. Type of Structure No. of Bedrooms
t5 0-(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals l) La atories Bathtubs
Showers 0 Kitchen Sinks Laundry Tubs Garbage Grinder( Other 0 /�
6. Liquid Capacity of Septic Tank Material of Septic Tank 6 r 0IV19R aS
7. Soil Conditions: Type of Soil Maximum ground water table-- ,ZJ
(Sand,Grav 1,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well from adjacent wells Zj d f
9. Distance to nearest water course, drainage ditch, storm drain or embankment, �d d
10. PerCo,ation Tests: Time for V drop in soil test -PvLc. Classification of soil
11. Miirimum square feet of effective seepage area required d C)
i
12. Leaching System: Number of trenches Length Width Total 0,A_
t
Other ih<d', X
SignaturelT'_��rf„
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
09/A
-- ----------417/ w CeN57�- �r�
Permit Issued 19 By
Installation Completed, Inspected and Approved 19_!�P4 By