HomeMy WebLinkAboutSeptic Repair 731 Graham Road `'
TOWN OF SOUTH WI N DSOR a
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit toialdloe Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date, 744 19
A permit is requested for repair or construction of an individual sewage dispo al system concerning which the
following information is submitted: (�
1. Owner of Property Address of Owner Z.7n 0&4
2. Location of Property II Lot. No.
3. Type of Structure //tc. No. of Bedrooms_
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ L.
5. Plumbing Fixtures: Water Closets 2— Urinals 6 f Lavatories,-2— Bathtubs _
Showers j Kitchen Sinks_ Laundry Tubs Garbage Grinder---j Other C�
6. Liquid Capacity of Septic Tank 7 f 0 Material of Septic Tank_C& 4 4 c 0
7. Soil Conditions: Type of Soil 0 eh Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well 7T�t— from adjacent wells /> d
�
9. Distance to nearest water course, drainage ditch, storm drain or embankment C1 7-
10. Percolation Tests: Time for 1" drop in soil test /—n a✓ Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Total
Other
Signature , l� e�
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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♦ I + Ct
Permit Issued 19 By
Installation Completed, Inspected and Approved_/ 19� By