HomeMy WebLinkAboutSeptic Repair 77 Foster Road c4a 4:5 F�;Z,
TOWN OF SOUTH WI N DSOR �
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or 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 disposal system concerning which the
following information is submitted: sy
1. Owner of Property Address of Owner_
2. Location of Property �7 7 ��� �4 Lot. No.
3. Type of Structure 3
'tnW(D..111'n ,ommercial Building,Store,etc.) No. of Bedrooms
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets / Urinals Lavatories- /— Bathtubs
Showers Kitchen Sinks_ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tan Material of Septic Tank - —---
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand',Gravel,C�etc.)
8. If not served by public water supply: Distance from Owner's well from adjacent wells,. d
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test 1T�_Classification of soil_ K�_
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length - Widths Total77
Signature
tensed Installer}
(Sketch showing all minimum distances and other details required below)
77 7 . P,L
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 BY