HomeMy WebLinkAboutSeptic Repair 540 Main Street TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. /ILVP&Q-/
TO THE BUILDING DEPARTMENT: ' Date. �r/isyEiu►i��'2 19—�
A permit is requested for a a' or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property&LLL 40ASSAAM16 Address of Owner Sy0/Y.414 VA.gt&r
2. Location of Property S!A.Me, Lot. No.
3. Type of Structure &JA -I-1-16- No. of Bedrooms T
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urihals-- Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Gatbage Grinder Other
6. Liquid Capacity of Septic Tank t a.SD "l.4,Ew4$ Material of Septic Tank 0014C Z&-rw�
?. 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 P"Ll C from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soit.test_.1tAtlrJ"-r-gE'S Classification of soil
11. Minimum square feet of effective seepage area required 200 A. FED
12. Leaching System: Number of trenches I� _ Length 4�r—C'`4 Width-2-s.S sCE6T Total c .rt1pr
Other
Signatur
( censed -taller)
(Sketch showing all minimum distances and other etails requ� ow)
st=� SK15TC14 CW 2zrvdr2z6 s#DE, g 3,;� 777 -
Permit Issued d(a1/EMAE2 19 69- B-Y12 Ov 0
10,
Installation Completed, Inspected and Approved 196-,9 B 1� ))�
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