HomeMy WebLinkAboutSeptic New 635 Graham Road i
TOWN OF SOUTH WI N DSOR h
BUILDING DEPARTMENT t
South Windsor, Connecticut C
Application for Permit to Install or Repair Individual Sewage Disposal Syste2dt
Application No.—
TO THE BUILDING DEPARTMENT: Date r,r , ,� 19L
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 6 y I uc r c—n )' Address of Owner 63 5-
2. Location of Proper ot. No.
3. Type of Structure �D w V&1 j.(�7 C4 No. of Bedrooms_
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_��
5. Plumbing Fixtures: Water Closets Urinals Lavatories f Bathtubs__ L )
Showers_ Kitchen Sinks—�— Laundry Tubs Garbage Grinder_--- Othe 0 / &�hc,�
6. Liquid Capacity of Septic Tank :;2'5-0 s/ 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 Owners well '7f'� 1 from adjacent_wells_�O
9. Distance to nearest water course, drainage ditch, storm drain or embankment 77
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
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12. Leaching System: Number of trenches Length,/�; a Width ? O' Total
Other
Signat
(Licensed Installer)
(Sketch showing all minimum distances and other details required below77/
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Permit Issued 19 By -
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Installation Completed, Inspected and Approved /3 14101f-iti. -19 B
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