HomeMy WebLinkAboutSeptic New 658 Ellington Road TOWN_ Off' SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. �,5X�
TO THE BUILDING DEPARTMENT: Date. O
19 6
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: ,Q /
1. Owner of Property A l F r- .,rc tS Address of Owner_1"e 1 a Iry
ral-Ir2. Location of Property & I f i reA b tv Aef s PCch r R,.-V 1 e tJ Lot. No.
3. Type of Structure BIAOIL n(I u *�26 rC No. of Bedrooms 3
7f— (Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closetsa, Urinals Lavatories 1. Bathtubs_
Showers'_ Kitchen Sinks_1 Laundry Tubs_ Garbage Grinder--a— Other 0
6. Liquid Capacity of Septic Tank /S d d Material of Septic Tank C a h-Q r+t,:t.P
7. Soil Conditions: Type of Soil _4A lY ef Maximum ground water table
(Band,Gravel,Clay,etc.)
8. If not served by
public water supply: Distance from Owner's well Qoi6i from adjacent wells '
9. Distance to nearest water course, drainage ditch, storm drain or embankment ��b d �-
10. Percolation Tests: Time for 1" drop in soil test J Jh 1 tjM Classification of soil A
11. Minimum square feet of effective seepage area required se
12. Leaching System: Number of trenches - Length Length �s Width a Total a c,&
Other /
Signature os..,..�
(Licensed installer)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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