HomeMy WebLinkAboutSeptic New 1736 Ellington Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System ��'
Application No.
TO THE BUILDING DEPARTMENT: Date.L C.(
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
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1. Owner of PropertyT� �Z l t// !f /4 411,S'_Address of Owner
2. Location of Property /736 4y� —ald., _e� Lot. No.
3. Type of Structure C 6 M it P rC/4(Dwelling,Commercial Building,Store,etc.) No. of Bedrooms
4. Number of Families or Persons to Occupy Premises_ ly4X 16
5. Plumbing Fixtures: Water Closets Z Urinals O Lavatories Bathtubs r
Showers_6 Kitchen Sinks d Laundry Tubs_ Garbage Grinder____S2_ Other go /
6. Liquid Capacity of Septic Tank 41� �) Material of Septic Tanker c���P ( /( i G �f.1 i Is
7. Soil Conditions: Type of Soil e- Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well f 7 from adjacent wells f /s'O
9. Distance to nearest water course, drainage ditch, storm drain or embankment �t r�0 `
10. Percolation Tests: Time for 1" drop in soil test Jv) /Ain Classification of soil
11. Minimum square feet of effective seepage area required _-A
12. Leaching System: Number of trenches 2 Length Width Total las: 2
Other
SignaturC&Ge1-1„_ 6 r
(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 J1 Qcral3 r-X 19 67_ By
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