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HomeMy WebLinkAboutSeptic New 222 Graham Road TOWN OF 'SOUTH WI N DSOR BUILDING DEPARTMENT �a South Windsor, Connecticut G2 6 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: ) 1. Owner of Property-as,.. .n.,.a9,e ap s Address of Owner Z?a 2!, cz"r 2. Location of Property 'w . h a,�. 1c�. Lot. No. 3. Type of Structure I J y?�. w No. of Bedrooms (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).arL r 6. Liquid Capacity of Septic Tank [��'c-)o1 �sy Material of Septic Tank 7. Soil Conditions: Type of Soil •,d Maximum ground water table —�S J (Sand,Gravel,Clay,etc.) J 8. If not served by public water supply: Distance from Owner's well from adjacent wells —2J 9. Distance to nearest water course, drainage ditch, storm drain or embankment )CC> 10. Percolation Tests: Time for 1" drop in soil test Classification of soil E 11. Minimum square feet of effective seepage area required 12. Leaching System: Number of trenches Length L!Y<2; < Width ©•� Total �d Other Signature Licensed Installer (Sketch showing all minimum distances and other details re uired below) b r= ...�.�. _ Permit Issued 19 By jr Installation Completed, Inspected and Approved 0(- Ma y iiL,6—f By I • ' f n q' �7/Ci4t�rarr 2.4 t,