HomeMy WebLinkAboutSeptic Repair 38 Hayes Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to hVIN54 or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date
following information is submitted: 19�
A permit is requested for repair or construction of an individual sewage di os ring al system concer which the
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1. Owner of Property ,�c �(` �(XJ r Address of Owner
2. Location of Propert r
Lot. No.
3. Type of Structure No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ ,s--
5. Plumbing Fixtures: Water Closets �= — Urinals C 7 Lavatories `> Bathtubs 4 -
Showers i') Kitchen Sinks Laundry Tubs 6' Garbage Grinder 12 Other
6. Liquid Capacity of Septic Tank 2 S C, Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table f
(Sand,G avel,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 emba i ment r 5` ._?
10. Percolation Tests: Time for 1" drop in soil test ��. � Classification of soil t
11. Minimum square feet of effective seepage area required_
12. Leaching System: Number of trenches Leength /& Alt •Width Total
Other
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Signature �4. i/,
(Licenses ine le
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
Moll'..
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