HomeMy WebLinkAboutSeptic New 95 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. 711,500,
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 (1 ,2&I-k i0 ry &nn,t g�'b L",Address of Owner. &,&
2. Location of Property /`7 yS 12Q Lot. No. ?/
3. Type of Structure 42w z u—/Iva 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_1_ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 'F/Ogo Material of Septic Tank "v i'A -
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,Clay,etc.)
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8. If not served by public water supply: Distance from Owner's well 46A 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 trenches Length_ / _ Width Total 3y7
Other
Signature / r
(LAcensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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THIS PLAN TO BE
SUBSTANTIALLYENGINEERING AND LAND SURVEYING
CORRECT; 740 NO.MAIN STREET. CROSSROADS PLAZA
NO. 373Z WEST HARTFORD 7.CONNECTICUT
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