HomeMy WebLinkAboutSeptic Repair 954 Main Street r,rE PpIJ;, TOWN OF SOUTH WI N DSOR PF.0--o•r
IN C.4.d(/e ../4 Lae BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. exf)-7-7,D-/
TO THE BUILDING DEPARTMENT: Date. 1YV APAL/4. 19 -70
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/E-.//&- 64 f✓Eu,sx ze-)t Address of Owner 94'1 IV-41,-r -Tree arT-
2. Location of Property - VA.7&r- Lot. No.
3. Type of Structure 7D wW"1"14 No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises CO /�A•�9/�1/
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 da vea rrF
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 74-LP`t from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment s"a(r •rn [SOLooi<
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 Length Width Total
Other D,)l>0d of kb C1. N/Vacs .- G 3 ' V a /ppd RA Lon/s
Signature
/� (Lice-ged nstaner)
(Sketch showing all minimum distances and otheridetail re `We< ow�
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Permit Issued e2c't lgpg� k. 19 7 fe By P&I C D-lAQ A S
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Installation Completed, Inspected and Approved y27 APel." 19 20 By./L&/- 2fl,,F3,e4 ��,
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