HomeMy WebLinkAboutSeptic New 00 Governor's Highway (3) s
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TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal system
Application No. Jac
TO THE BUILDING DEPARTMENT: Date /d Z 19 lo.�
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 ��fc�' o �0 A Address of/Owner A-7 So
2. Location of Property 2S g a/ 0 � ( SDI eJ
Lot. No.
3. Type of Structure Tie/0 4- No. of Bedrooms
(Dwelling,Commercial Building,St re,etc.)
4. Number of Families or Persons to Occupy Premises_ y80 pe•QScitl -
5. Plumbing Fixtures: Water Closets 1Z%L Urinals /Q Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other J 34,o fey SX
6. Liquid Capacity of Septic Tank B OQO Material of Septic Tank C'D.1 2Ad71.d�✓4:71<J
7. Soil Conditions: Type of Soil *5'441& Maximum ground water table /!
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well 7RO411k from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment Sa f
10. Percolation Tests: Time for 1" drop in soil test ®-" /ten. Classification of soil
11. Minimum square feet of effective seepage area required lead
12. Leaching System: Number of trenches Length Width Total
Other ���' IWA,'
.Cetlee A/moo _ �.
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
��So Sew /H.¢�re ��f /�/�i✓_
Permit Issued ` ® id 2 3 1943 By�
Installation Completed, Inspected and Approved 19- By
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