HomeMy WebLinkAboutSeptic Repair 792 Ellington Road TOWN OF SOUTH WI N DSOR
r,c,S r AI BUILDING DEPARTMENT P�2Msr
South Windsor, Connecticut ��••7I-� 7
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Application for Permit to Install �epairIndividual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date. /7 19�_
A permit is requested f repair r construction of an individual sewage disposal system concerning which the
following information is submitted: ff
1. Owner of Property &&7,/n/ JY,9 2-(J'e Address of Owner'79Z
2. Location of Property SAwtcr Lot. No.
3. Type of Structure t1! c No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises Cc+F c n) CAM/t Y
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank /• Material of Septic Tank
7. Soil Conditions: Type of Soil �I ft�ravel,Clay,etc.) Maximum ground water table
(Sand,G
8. If not served by public water supply: Distance from Owner's well from adjacent wells
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 /6 EE C 3) Length /Sn F`T Width �3.Q 7- Total 17=5cl)c i
Other
Signature
((Lice 4 I etaller)
(Sketch showing all minimum distances and other de'�tails r q w/)
Permit Issued /'7 VcsrlE 19_ By
Installation Completed, Inspected and Approved_^T v C 19-2-1 By
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