HomeMy WebLinkAboutSeptic Repair 54 Hillside Drive iI -
TOWN OF SOUTH WINDSOR 41r
�E� P/ala BUILDING DEPARTMENT r� �T
13y South Windsor, Connecticut /Vv. -7/—ni
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date. IA A J u/A2 y 19-2-41
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 /a. Sr,4 i P.t,L.4Ai0 Address of Owner sY «sib ✓J,4 i v y
2. Location of Property Cot. N -3
3. Type of Structure_ D„qjj(-LI,.t c, No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises�r�� (<) F'A t-L-4
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic TankA'x15rir4' Material of Septic Tank
7. Soil Conditions: Type of Soil_ C.'ZAV��- 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 trenches at t Q Length /6-0 =•t Width 2. S FT Total-37;a SQ FT
Other
Signatur ICJ
( ceT-ed Installer)
�bs1Ni it (u,yN>e be'1'o
(Sketch showing all minimum distances and oTher dDetails required below)
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Permit Issued Aja,442 19 1/ By°'
Installation Completed, Inspected and Approved /5 'JA,1U,*21 19 L7r By