HomeMy WebLinkAboutSeptic New 42 Kelly Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
` South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Applicatio N . /
TO THE BUILDING DEPARTMENT: Date 1911
A permit is requested for repair or cgpstruction of an individual sewage disp al system concerning which the
following information is sub ' ted: MERvF f+wRn��r/�.-
1. Owner of Property Address of Owner
2. Location of Property Lot. No.
3. Type of Structure No. of Bedrooms
71 welling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises
5. Plumbing Fixtures: Water Closets I Urinals "'— Lavatories_ /` Bathtubs _
Showers _ Kitchen Sinks_ Laundry Tubs Garbage Grinder Othe
6. Liquid Capacity of Septic Tan ' Material of Septic Tank
7. Soil Conditions: Type of Soil If f tc Maximum ground water table
Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well from ad'acent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment
oe
10. Percolation Tests: Time for 1" drop in soil test ' lassification of soil
11. Minimum square feet of effective seepage area required
12. LeachipA Syste : Number of tr riches Lenh 1�4 d Widt Tota1 c7
m t
Other
Signature e-
Rensed Installer)
(Sketch showing all minimum distances and other details required below,
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EI-41 7 T
Permit Issued 19 B
Installation Completed,Inspected and Approved -10— By