HomeMy WebLinkAboutSeptic New 00 Governor's Highway (2) TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System j4rd
Application No.
TO THE BUILDING DEPARTMENT: Date_ ? A-7 19Z_I--
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property Pb`g rye Address of Owner
2. Location of Property Cb 'yb n�C h7/ LJ#�� �' Lot. No.
3. Type of Structure ��Lc n No. of Bedrooms
( welling,Commer ial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ -124`/
5. Plumbing Fixtures: Water Closets 2 Urinals_ Lavatories /3 Bathtubs y
Showers 0 Kitchen Sinks 3 Laundry Tubs 0 Garbage Grinder 6 Other 2 6�o i s--yf
6. Liquid Capacity of Septic Tank k&y-0 ,;2�=c Material of Septic Tank - C 0 S T
7. Soil Conditions: Type of Soil � A r0 Maximum ground water table w
(Sand, ravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well/)U 1Y«G from adjacent wells r�
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 z-�-o
11. Minimum square feet of effective seepage area required -al 6 D
12. Leaching System: Number of trenches � Length Width 3 Total
2t G�
Other
J
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.,L�,`
TO THE BUILDING DEPARTMENT: Date /1/ #-Y 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
�✓1. Owner of Property W P-4240 " ?D 1-14 2"14, Address of Owner 2,00 J V 4L)VO V Aye-
2. Location of Property y QV&0, As"dA-J Lot. No. -�
3. Type of Structure No. of Bedrooms f—
(Dwelling,Commercial Building,Store,etc.)
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 Tank 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 Total
Other
Signature
-(Licenbea Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
9
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