HomeMy WebLinkAboutSeptic Repair 128 Farmstead Drive Y TOWN OF SOUTH WI N DSOR
�FE I�A�a BUILDING DEPARTMENT �f'���T'
�'/ --• South Windsor, Connecticut A&7a'
Application for Permit to Install or a ai Individual Sewage Disposal System
Application No._a?I t?O•/
TO THE BUILDING DEPARTMENT: Date
A permit is requested for a ai or construction of an individual sewage disposal system concerning which the
following information is submitted: //
1. Owner of Property/�A17ffldW T ZA&,a*KL .Tit Address of OwnerlA ¢ iiOrtMslE14 oz of r
2. Location of Property SAMO Lot. No.
3. Type of Structure *b So" IN G No. of Bedrooms
� (Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises OM19 te) Aaelt
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank AfKttTIN9 Material of Septic Tank
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 A AV Or Total
Other we t a l 7So-9AA.Ac&y Z w sys`Aj.a PAWS rub F/sas
Signature
��s(E>I �eyr)�w��y,
(Sketch showing all minimum distances and of er etmisJregwred below)
Scar mVVA FAA. aKEr@ W.
Permit Issued /it 1920- By MML E0 JV VAAX
Installation Completed, Inspected and Approved /4, *Tu.)l 19 74 B (�
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