HomeMy WebLinkAboutSeptic New 180 Laurel Street Ir
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TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT �
South Windsor, Connecticut i /ilf I �°.�
Application for Permit to Install or Repair Individual Sewage Disposal System ,
Application No.
TO THE BUILDING DEPARTMENT: Datee a e 7 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 P-&x — uu&—}¢.� Address of Owner /8O �"ram
2. Location of Property .rAa(=)_ fa�Y -il �
' . Lot. No.
3. Type of Structure � W C—I l h C Dwelling,commercial Building,Store,etc.) No. of Bedrooms_
4. Number of Families or Persons to Occupy Premises_ �f
5. Plumbing Fixtures: Water Closets Urinals Lavatories.�s_ Bathtubs_
Showers_ / Kitchen Sinks��_ Laundry Tubs --- Garbage Grinder Other V 4b
6. Liquid Capacity of Septic Tank f O 0O G11,
1)), J Material of Septic Tank G�U.�-�,d e,
7. Soil Conditions: Type of Soil CUe.v f d n--, Maximum ground water table_ !j'
,----(Ra1Jdfc.ravei,Clay, tc.)
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 F3,O"
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 �i Length / G(D Width u TotaL30C)
Other
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
-L44it\
y x >e N x � X
1 '�y � I .� I •f�
Permit Issued 19 By
Installation Completed, Inspected and Approved g By
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