HomeMy WebLinkAboutSeptic New 87 Hayes Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. ley
TO THE BUILDING DEPARTMENT: Date /? 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 1722"D/F iJ /(fyr7 v 5 tntAddress of Owner . a Lv ./ ,
2. Location of Property Lot. No. f�io
3. Type of Structure No. of Bedrooms 3
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories_ Bathtubs
Showers_ Kitchen Sinks _ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tan /e /mod 4MP I Material of Septic Tankz4Z41e,
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's wel 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 ✓S�
12. Leaching System: Number of trenches - Length. f Width 2 Total X4 Z 4
Other �`
Signatur
Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 10 _ By