HomeMy WebLinkAboutSeptic New 1648 Main Street Yi o- TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal ,S/ystem
Application No. �`y�Z
TO THE BUILDING DEPARTMENT: Date. 4I/n 19 6e7w
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 ;.eg/a•i-e Address of Owner /'7,oy,, s 0/,
2. Location of Property 1 6 S/k 11 1/l-i�r Lot. No.
3. Type of Structure D W No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets 1 Urinals _ Lavatories -3 Bathtubs _
Showers Kitchen Sinks, t_ Laundry Tubs Garbage Grinder morother
6. Liquid Capacity of Septic Tank -i o-0 Material of Septic Tank 0.E'/ti
7. Soil Conditions: Type of Soil s,-g Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well Its' from adjacent wells 74
9. Distance to nearest water course, drainage ditch, storm drain or embankment .2 S Ff-
10. Percolation Tests: Time for 1" drop in soil test / ', J a .S' ,}'L Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches of Length c2 Width Total
Other
Signature
censed Installer)
(Sketch showing all minimum distances and other details required below)
6g ems-:.
� I
I
I 1 1
1 �
1 I
i
I i I
I
I�lAin/ EEir
Permit Issued 19 By
Installation Completed, Inspected and Approved it -7,-Pvua,02 19 6` By