HomeMy WebLinkAboutSeptic New 00 Newberry Road (2) TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT d PAOle
South Windsor, Connecticut
Application for Permit to k4fiftw Repair Individual Sea 7 w �e Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date 19��
A permit is requested for repair or construction of an individual sewage sposal system concerning which the
following information is submitted:
1. Owner of Property �jAddress of Owner
2. Location of Property //,�►X�'2 ,� e. ^h TAf� Lot N
3. Type of Structure �GtJ e�,y r► No. of Bedrooms .3
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals �_ Lavatories 2_ Bathtubs _
Showers_ / Kitchen Sinks_ Laundry Tubs_ Garbage Grinder � � Other/,
6. Liquid Capacity of Septic Tank ` c,1SD��Material of Septic Tank -�I� ,�—�/�
7. Soil Conditions: Type of Soil Maximum ground water table_
(and,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well ?' 25`/ from adjacent wells f�,_
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test M/A<S Classification of soil
11. Minimum square feet of effective seepage area required
12. LeachingSystem: Number of trenches_ / Length /—Zf � Width .3d Total
Other ^�/` �r �i Ar�� �e r,!�_/who ff_
Signature—(, a Q�!
(Lac nsed Ins ler)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
C�
s
N;x
j
V�
�Ree
5 °
, Je
l�
a
c
r