HomeMy WebLinkAboutSeptic Repair 24 Lewis Drive (2) s 7/ q
- 1ry TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
&REQA South Windsor, Connecticut
Application for Permit to Install or epai Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date. 6 - — ='9 19 -7
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 `owg`�FTO Address of Owner
2. Location of Property a-,00,/W,4-- Lot. No.
3. Type of Structure lcadk� 6, 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 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 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&c-e t-�) Length /S"42 Er Width 1► FF r Total 4-SG S,� FT
Other
Signatur
(License nstaller)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19,/ By <,J,
Installation Completed, Inspected and Approved 3c g/i�.v 19�L By 1�uf�
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