HomeMy WebLinkAboutSeptic Repair 2660 Ellington Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT w J!
South Windsor, Connecticut
Application for Permit to Ir Repair Individual Sewage Disposal System
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Application No.
TO THE BUILDING DEPARTMENT: Date. ���1 11 .7 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: 1
1. Owner of Property i /�c 1^ Address of Owner. G, 6 D f y '1&1
2. Location of Property AL Zh A"'11/
// Lot. No.
3. Type of Structure �l Z g--/ "&Z
No. of Bedrooms_
(Df,Vling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises /' G����
5. Plumbing Fixtures: Water Closets 2 Urinals d Lavatories 1_ Bathtubs -:Z-
Showers Kitchen Sinks` Laundry Tubs_/ Garbage Grinder--.&_ Other_ 6
6. Liquid Capacity of Septic Tank Z-:�� Material of Septic Tank
7. Soil Conditions: Type of Soil Q3 r o V e 1 Maximum ground water table
(Band,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well 4 � /
��_from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment �',S-
10. Percolation Tests: Time for 1" drop in soil test :3 4i a_gK :t _Classification of soil ,
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Z Length O Width__,Ia Total Id D
Other
Signature_
(Licensed Insiffiler.,
(Sketch showing all minimum distances and other details required below)
l6' 3r'
Permit Issued 19 By
Installation Completed, Inspected and Approved TtJ t� 196-77 By 1147—