HomeMy WebLinkAboutSeptic New 260 Graham Road M
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal S/yytem
Application No. 1
TO THE BUILDING DEPARTMENT: Date /-"'— aye 19
A permit is requested for repair or onstruction of an individual sewage disposal system concerning which the
following information is sP itted:
1. Owner of Property Address of Owner o�ed
2. Location of Prop ;� Lot. No.
3. Type of Structure No. of Bedrooms
(Dwellirm*
o ercial Building,store,etc.)
4. Number of Families or Persons to Occupy Pres_
5. Plumbing Fixtures: Water Closets r Urinals Lavatories_Z Bathtubs
r
Showers Kitchen Sinks•_ Laundry Tube Garbage Grinder /YD . Other
6. Liquid Capacity of Septic Tank 12✓`® Material of Septic Tankze:::�� I T/,�e!o o
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Grave lay,etc.)
8. If not served by
public water supply: Distance from Owner's well ✓ �7 from adjacent wells�'s/
9. Distance to nearest water course, drainage ditch, storm drain or embankment Q.0 o
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 f'v/4 61" Width Z Total
Other
Signaturee4 __�
licensed Installer)
(Sketch showing all minimum distances and other details required below)
/ a 1.3 r
Permit Issued 19 By
Installation Completed, Inspected and Approved o2 l 19 63 By
A ti ! �.
r. � .. ..
TOWN OF SOUTH WI N DS®R
BUILDING DEPARTMENT
South Windsor, Connecticut
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 t. Address of Owner, •�l' it: / w L
2. Location of Properiyl�l - .� ! i �, ,�' Lot. No,
3. Type of Structure No. of,Bedrooms 1_3
Dwelli g,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Pzmises_ t
i
5. Plumbing Fixtures: Water Closets Urinals -t' , La atories Y/-- '—iu'_Bathtubs 2,---
Showers_ Kitchen Sinks�Z,,e Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 11-:7-15Tf Material of Septic Tank
7. Soil Conditions: Type of Soil 1.. �,( Maximum ground water table
(Sand,Gravel,Clay;etc.)
8. If not served by public water supply: Distance from Owner's well4 ,�6 from adjacent wells 21
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 j Length Width,&�C/ Total
Other
Signature ,.7 - � _.(. 2.Z-� Z
(11censed installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 10 By
Q0
P�
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