HomeMy WebLinkAboutSeptic Repair 700 Governor's Highway TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
/ South Windsor, Connecticut
G
Application for Permit to Install o e air Individual Sewage Disposal System
Application No.104069—/
TO THE BUILDING DEPARTMENT: Date__ J-0 e6aag-A- 1949
A permit is requested for a air or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property •�iaVt D�is./yos�L�/�.l a Address of Owner l 8 24-MJI
2. Location of Property -lea► Ql(J/hte42 1 A41#&jAM Lot. No.
3. Type of Structure bWgt4Lddi1 No. of Bedrooms 13
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises Dig ZIJ FM/L✓
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank '7SO QAJ-&gyd Material of Septic Tank S7Vie — S-Yar to4g
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 'Q.T40 Sy a c.eLc L
12. Leaching System: Number of trenches Length Width 42, Total .79IS p I
Other
Signature 2 4 Z
(LicenaIgstaller) 3y79/a
M(Licensed
(Sketch showing all mini�m�um distances and other a al s required below)
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Permit Issued / 6a m4e2 196_ By 4.,
Installation Completed, Inspected and Approved -2/ 4-ro8r/L 19 6? BY