HomeMy WebLinkAboutSeptic New 146 Kelly Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
�6South Windsor, Connecticut
ppliccition for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date_ Y/..? 19-c/,
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 Jo-z-7-1,,4!4. MAJk Arab A Address of Owner
2. Location of Property TAVA 7 0 Lot. No.
3. Type of Structure i�) w flllAi No. of Bedrooms
(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 Tank-7:�O/O •A0 AV±*R Material of Septic Tank- S4-e4P-l
7. Soil Conditions: Type of Soil Maximum ground water table- iYe wE
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well 7,s' from adjacent wells 7s
9. Distance to nearest water course, drainage ditch, storm drain or embankment 4l-.0 "'r
10. Percolation Tests: Time for 1" drop in soil test Classification of soil / 1�4 7 i 10"
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches a2 Length Sj O Width a r f Total "
Other
Signature w-ti _ �
(IAcensed Installer) + f
(Sketch showing all minimum distances and other details required below)
EY/sT/nl�
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Permit Issued ' -. 9 B `7 + a
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Installation Completed, Inspected and Approved 19 By