HomeMy WebLinkAboutSeptic Repair 642 Ellington Road SEE �A,a TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT PArfem; '
is,, South Windsor, Connecticut IV6- W— Log-
Application for Permit to Install or Re air Individual Sewage Disposal System
Application No. /a!/Zz)—a.
TO THE BUILDING DEPARTMENT: Date__ i! ��c►E .6 e=/Z 19 70
A permit is requested for epair r construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property 614.6iA09 S,40A-st,44 Address of
s�Owner_ Goa Eu1nlo7-oN ROAD
2. Location of Property_SAn4 Lot. No.
3. Type of Structure 1u04-e.Lrn/G No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises QNE e13 JCAMi---y
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank�X� Material of Septic Tank
7. Soil Conditions: Type of Soil-qAAJD X "AYEL. Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well 15 FT 1- from adjacent wells 775 /-T t
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 trenches6"r Cs Length /aa FT Width 3*0 FT Total,3� Fr
Other P4-u5 Sp",6' of ow-h FIELD.
Signature
Licen d =taller) +
.�►� svi�uasr Cw�.Ssge/a.�
(Sketch showing all minimum distances and of er details required below
lot
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Permit Issued I q �EQEsMr6 E2 19Z_ By
Installation Completed, Inspected and Approved /S �FeE�I/362 19?a B �
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