HomeMy WebLinkAboutSeptic New 10 Hayes Road TOWN OF SOUTH WI N DSOR par4MIr
Sy c�r1EmK�_sgl� BUILDING DEPARTMENT
South Windsor, Connecticut IJo.7I-o 79.
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. m3ill 71—
TO THE BUILDING DEPARTMENT: Date of M a&*N 19 711_
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of PropertYPHILIP(2.4 Q&A&1A tom. Smi-M&Address of Owner .eoAAi
2. Location of Property J� /a �D&DOLAIArn NgylS I�SRgNgM� Lot. No. D$67S.0
3. Type of Structure bW W,,L1 de No. of Bedrooms._._
(Dwelling,Commercial Budding,Store,etc.)
4. Number of Families or Persons to Occupy Premises_yn1E tl� LAN1�iu
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Griniler Other
6. Liquid Capacity of Septic TankN�aa0 qp«g$ Material of Septic TankCsaNcQETi 1 R,stV NDA,
7. Soil Conditions: Type of Soil QkaAVOL. 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 trencheslr%40 Ltd Length(ad 04r Width 2. fi FT Totall is Ift R•T'
OtherP4.VS laxibx10 1b&*e1C-CoL4r DII•VWi6.L
Signature
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J. q•isloflJ
(Sketch showing all minimum distances and of er details re P d below
SiE oVPr2 FOIQ sKiTclf.
Permit Issued OI MA4C N 19 �1 Byi _
Installation Completed, Inspected and Approved ®2 #4A4C P
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