HomeMy WebLinkAboutSeptic Repair 19 Foster Street IV 0 IEE- � r�
/ TOWN OF SOUTH WI N DSOR
dNL BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. /
TO THE BUILDING DEPARTMENT: Date_ n ,
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:l-_[T + P �d '�
1. Owner of Property ' /)JJ K p �A�ddress of Owner- � t:— LhA/�l
2. Location of Property I rO 5�� /\ )/ , Lot. No.
3. Type of Structure_- LV ELL-1 V C No. of Bedrooms_
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises ,A/C
5. Plumbing Fixtures: Water Closets__ Urinals Lavatories Bathtubs /
Shower Kitchen Kitchen Sinks` Laundry Tubs ' Garbage Grinder '�`~ Other
6. Liquid Capacity of Septic Tank A�C GALA Material of Septic Tank C 4 X"IC
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 Total
Other
� ) Signatur r'
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(Sketch showing all minimum distances and other details required below)
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� 9'
4.
Permit Issued 19 By.
Installation Completed,Inspected and Approved 19 By