HomeMy WebLinkAboutSeptic Repair 73 Hillside Drive o, • ♦ t
TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT �Era9i-�
0 6ay-J193 South Wi Connecticut
Application for Permit to Install Repai Individual Sewage Disposal System
Application No.4W�o,7/—/
TO THE BUILDING DEPARTMENT: Date_ /6 A04/A, 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 fil-ww 'IQNecs Address of Owner '-ALd-61b4g, Z 1�i VO.--
2. Location of Property SLIME Lol t No_
3. Type of Structure EI��L/n/G No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_JQiNE C/) 1Co9,on1-%4
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank E1C1A77A1f; Material of Septic Tank
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 well W OC r 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 Widt Total
Othe C0 o o x c. --90A VA71-01Y.
Signature-..
br ekedJ tall
""_Shed
(Sketch showing all minimum distances and o erIe stalls requir ow
Permit Issued /6 442/L 1971 By.
Installation Completed, Inspected and Approved AR., 197/ By X4!
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