HomeMy WebLinkAboutWell New 440 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. /lr4 I"� 19
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& ��l .� e 4-::� Address of Owner ���U �: .;�_ _
2. Location of Property tt iJC'lh /y/ �J f Lot. No.
3. Type of Structure �1 64 IC � ,� No. of Bedrooms
(I ,elling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ e.!z r
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5. Plumbing Fixtures: Water Closets Urinals _ Lavatories _ Bathtubs `)
Showers_ Kitchen Sinks Laundry Tubs_ Garbage Grinder Other _
6. Liquid Capacity of Septic Tank A"6 Material of Septic Tank C X C r At
7. Soil Conditions: Ty
pe of Soil f j�� tug� i, ��.ys.� i r
Maximum ground water table �
(Sari ,Graver,Clay,etc.)
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8. If not served by public water supply: Distance from Owner's well from adjacent wells 64
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 Lengthy Width `? '' Total
Other
Signature .-i,�—
S. (Licensed Installer)-
showing all minimum distances and other details required below)
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Permit Issued _g2 19�� By cc cr cc�[
Installation Completed, Inspected and Approved 19-" ByJi / ���_