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HomeMy WebLinkAboutSeptic New 1700 Ellington Road TOWN OF SOUTH WI N DSOR . BUILDING DEPARTMENT 00271 South Windsor, Connecticut ZV;� Application for Permit to Install or Repair Individual Sewage Disposal System Application No. TO THE BUILDING DEPARTMENT: DateeeA --,,2 . rsz 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 1ZAddress of Owner 2. Location of Property Lot. No. 3. Type of Structure (Dwelling,C mmerci No. of Bedrooms_ OOF u ing,Store,etc.) 4. Number of Families or Persons to Occupy Premises_ 5. Plumbing Fixtures: Water Closets Urinals �— Lavatories_ Bathtubs Showers Z----'Kitchen Sinks .4 Laundry Tubs �Garbage Grinder Other 6. Liquid Capacity of Septic Tank_/if—O-e Material of Septic Tank --filer e 7. Soil Conditions: Type of Soil Maximum ground water table (Sand,Gravel,Clay,etc.) 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 Length Width Total Other Signature icensed installer) (Sketch showing all minimum distances an other details required below) Permit Issued 19 By Installation Completed, Inspected and Approved 19 By .✓ r . . ._ , _. � �y�---------�---, , cAi - sue' � �� a�' ��i s ti ate: ��©a (=LLiiJC-7GN ��D - - - 06/17/2005 FRI 11:05 FAX 860 644 7280 South Windsor Town Hall IR001 *** FAX TX REPORT *** ********************* TRANSMISSION OK JOB NO. 4404 DESTINATION ADDRESS 92822684 PSWD/SUBADDRESS DESTINATION ID ST. TIME 06/17 11:04 USAGE T 00' 37 PGS. 1 RESULT OK -- --�_....._.._......._...�....... .. ............ .........,._........_ .................... . . f - 3 • 5 .o—