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HomeMy WebLinkAboutSeptic Repair 1216 Main Street <ee P.41D TOWN OF SOUTH WINDSOR € BUILDING DEPARTMENT Q y South Windsor, Connecticut Application for Permit to Install or Repair Individual Sewage Disposal System Application No. d-'f3©7/-/ TO THE BUILDING DEPARTMENT: Date. 3o AP2lL 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 isle T 441 2.Ls. .12. Address of Owner iyl rp Ngirl Sr ,a cc&-rr 2. Location of Property&AgT S'/AE_ 4raont6, Lot. No. 3. Type of Structure D drL rJ No. of Bedrooms (Dwelling,Commercial Building,Store,etc.) 4. Number of Families or Persons to Occupy Premises_dNF el) r-A Q1,-y 5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other 6. Liquid Capacity of Septic Tank Ex ter 1N Material of Septic Tank c-oNo-i2 i,rE 7. Soil Conditions: Type of Soil SAn►l> Maximum ground water table (Sand,Gravel,Clay,etc.) 8. If not served by public water supply: Distance from Owner's well 7S F-r+ 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 u2 F Length(fo r--r Width 2,� lz'T Total 3'7S FT Other Signature (Licensed;nstalle" Ra tit S,WI-S4(EctsKi (•I� s 9-3981�� (Sketch showing all minitn�um distances and other details required below) Permit Issued 19_ZL By 1�l.0 Installation Completed, Inspected and Approved 30 Ap,211` 19 '71 By, r W 2� 49 zo � ► 41, ► 1 1009 20 SOUTH ►tJiN.)SOP' i>�_i �.:.��t'(`i Lt7NTPOL LC (ATiON 121` MAIN SradaT '01O,SC: W.-r. FAA12.0 IJ&. df/��i=1:�tvlt T'71-19 PIPE+ �� A t3.