HomeMy WebLinkAboutSeptic Repair 2735 Ellington Road TOWN OF SOUTH WI N DSOR
J 0 BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit t.,1,41,11100.r Repair Individual Sewage Disposal System
Application jN�o.
TO THE BUILDING DEPARTMENT: Dat ,lam 19
A permit is requested for repair or construction of an individual sewage di�posal system concerning which the
following information is submitted:
1. Owner of Property f Address of Owners,
2. Location of Property -1 7 -41 i Ae2 Y Loth o.
3. Type of Structure 10 141 C.��� No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ _
5. Plumbing Fixtures: Water Closets Urinals Lavatories_ Bathtubs !
Showers O Kitchen Sinks ` Laundry Tubs_ Garbage Grinder_ Other Q
6. Liquid Capacity of Septic Tank 7��U Material of Septic Tank_C d /Y a ^ 0_Q—_�—--
7. Soil Conditions: Type of Soil Maximum ground water table Q
(Band,Grav 1,Clay,et .)
8. If not served by public water supply: Distance from Owner's well i from adjacent wells /7V
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test / 6 Classification of soil
11. Minimum.6quare fe
12. Leaching System: Number of trenches Length Width Total 10A CA
Other 'C.Orl-STI IV 14 PA
Signature
le-hhl
(Licensed Insta ler)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By