HomeMy WebLinkAboutSeptic New 137 Farnham Road ' r -
TOWN OF SOUTH WI N DSOR
'96 BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. �e
TO THE BUILDING DEPARTMENT: Date l0 19
A permit is requested for repair or construction of an individual sewage dispos system concerning which the
following information is submitted:
C�A���
1. Owner of Property �i9SSa'f Address of Owner_ 1-37 /aa/.
2. Location of Property XY zi`�ti' ✓��d '�� Lot. No.
3. Type of Structure No. of Bedrooms
(Dwellinvises
mmercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Pre _
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other ,
®6. Liquid Capacity of Septic Tank Z D Material of Septic Tank C"®�C, �iYi J�Ti%✓
1.
�/�/+'�� �f Maximum ground water table j4 s,yc� e 61 v
7. Soil Conditions: Type of Soil .?
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's wel=bankment
V�✓c from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or
10. Percolation Tests: Time for 1" drop in soil test / Classification of soil
11. Minimum square feet of effective seepage area required
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12. Leaching System: Number of trenches_ Length Width Total ��a
Other
Signature
(Lice d I tall
(Sketch showing all minimum distances and other ails required below)
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Permit Issued 19 By /
Installation Completed, Inspected and Approved P MAY 19 b7 By