HomeMy WebLinkAboutSeptic New 17 Gulley Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT , 2Gg
South Windsor, Connecticut GK
Application for Permit to Install or Repair Individual Sewage Disposal stem /
Application No.
TO THE BUILDING DEPARTMENT: Date/0Jc� 19 Z,,AL
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 l Address of Owner
2. Location of Property / �_�rr ,� %�lc; r C Lot. No. 3
3. Type of Structure z .r.1 1 . No. of Bedrooms,_
A
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ 'K--
5. Plumbing Fixtures: Water Closets C*!,:) Urinals Lavatories, ` Bathtubs_
Showers_ Kitchen Sinks / Laundry Tubs Garbage Grinder — Other 6 < r
6. Liquid Capacity of Septic Tank, OO O� 1 Material of Septic Tank_C ,,,- -L _
7. Soil Conditions: Type of Soil_ C-1a,j Maximum ground water table
(Band,G 1avel,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 .4z Q
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 Width Total
Other m e
Signatur
4-01LAficensed Instalie ) -
(Sketch showing all minimum distances and other details required below)
--77.
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x y �
ti Y X X X X
x X e1-Jr. A X
'• x x
Permit Issued 19 By f
Installation Completed, Inspected and Approved 19 By
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