HomeMy WebLinkAboutSeptic New 30 Hayes Road TOWN OF SOUTH WINDSOR
e0a BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. v
TO THE BUILDING DEPARTMENT: Date Z. 19
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 C/ �' p �/�' �re Address of Owner_
2. Location of Property r"g- Lot. No. &TO
3. Type of Structure l,[1 [ / No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ f 4f I'L Y
5. Plumbing Fixtures: Water Closets Urinals 'tip Lavatories_ Bathtu
Showers Kitchen Sinks*Sj '
Laundry TubsA�Garbage Grinder j�`Other .tip
6. Liquid Capacity of Septic Tan GG Material of Septic Tank- !s-nx 4-
7. Soil Conditions: Type of Soil � Maximum ground water table 1�✓
Sand,Gra el,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_, if 4i D
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 Lengthy 7 Width _ Total ® L— ��%
Other ! /C L o cla 4 e O
Signature o
i e s ller)
(Sketch showing all minimum distances and other details required below)
C` `
Q J
4
! 40
001 \ 3
i
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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