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HomeMy WebLinkAboutSeptic Repair 2228 Ellington Road -� TOWN OF SOUTH WI N DSOR BUILDING DEPARTMENT South Windsor, Connecticut Application for Permit to Iiglook Repair Individual Sewage Disposal System Application No. TO THE BUILDING DEPARTMENT: Date 19� A permit is requested for repair or construction of an individual sewage dis sal system concerning which the following information is submitted: ++ 1. Owner of Property W G,r► Address of Owner !C' �/- I� 0Q� �(,Q 2. Location of Property.?.ZaB - �I 'tQ Lot. No. 3. Type of Structure ©LUG.1 �N�? No. of Bedrooms (D ing,Commercial Building,Store,etc.) 4. Number of Families or Persons to Occupy Premises_ 5. Plumbing Fixtures: Water Closets, Urinals_ L atories Bathtubs Shower s Kitchen Sinks_ Laundry Tubs_ Garbage Grinder_ Other y 6. Liquid Capacity of Septic Tank �,,C'11 Material of Septic Tank 7. Soil Conditions: Type of Soil Maximum ground water table_. Sa ,Grafiel,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 l46 /n 10. Percolation Tests: Time for 1" ee��drop in soil test `3 A4/it Classification of soil 44 11. Minimum square feet of effective seepage area required 2 Zr 12. Leaching System: Number of trenches_ Length %r& I Width 2 Q Total fi I Other � � 1 Signatures (Licensed Ins .) (Sketch showing all minimum distances and other details required below) '00 do go 4W 40110- an so am I � --4m IVw ss 4W IP go 40'a � f W7/ � s � 8 .✓ Permit Issued 19 By Installation Completed,Inspected and Approved .'t6 fcuJf 19� E�'�