HomeMy WebLinkAboutSeptic New 34 Gulley Drive v TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
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TO THE BUILDING DEPARTMENT: Date—) 19 C 3
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: eot-inn,e M*trrq
1. Owner of Property r�l 'fI ' Ad ress of Owner_ DR.
2. Location of Property pp G- Lot. No. J/3
3. Type of Structure !J L&e c(--/k 4 No. of Bedrooms_
(Dwelling,Commerciale Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises ®1'9 � /L
5. Plumbing Fixtures: Water Closet Urinals Lavatories _ Bathtubs_
Showers _ Kitchen Sinks La t ndry Tubs_26� Garbage Grinder '— Other
6. Liquid Capacity of Septic Tank / 60 Material of Septic Tank �?L� AL—�
7. Soil Conditions: Type of SoiI CL -$!� Maximum ground water table &%)-
(San ,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well—tit 16 C from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment C k/,9- c>a/Al
10. Percolation Tests: Time for 1" drop in soil test Classification of soil fTK a✓lT`l6'.C�
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width- .� Total L/.�/��l
Other tt rr �`�� C t 7` 41 a Fr6- B LOC
Signature C
cens d Installer)
(Sketch showing all minimum distances and other detail required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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