HomeMy WebLinkAboutSeptic Repair 736 Graham Road TOWN OF SOUTH WI N DSOR %
BUILDING DEPARTMENT
Sauth Windsor, Connecticut
Application for Permit it Individual Sewage Disposal System
Applic ti n No.
TO THE BUILDING DEPARTMENT: Date 19�O
A permit is requested for repair or construction of an individual sewage d sposal system concerning which the
following information is submitted: �( `
1. Owner of Property �/l�. N/ / e,r/ Address of Owner d�2ta 4 s,
2. Location of Property yy�� •� 4 40 � 7 3<a Q2AHA.� R0.9;� Lot. No.
3. Type of Structure /✓Lv C/,/4 it¢ No. of Bedrooms _
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ 7 ,h, L
5. Plumbing Fixtures: Water Closets Urinals 6 Lavatories ` Bathtubs
Showers_ Kitchen Sinks r Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 7--S"0 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 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
12. Leaching System: Number of trenches 3 Length 6-0 Width -Y d Totaled X a d
Other
Signatur ,
( censed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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