HomeMy WebLinkAboutSeptic Repair 64 Manor Lane TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System`
Application No.
TO THE BUILDING DEPARTMENT: Date I�
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: rR or. a 1
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1. Owner of Propert _ !_ Address of Owner 60 `f
2. Location of Property Lot. No. 14t-t-- _
3. Type of Structure No. of Bedrooms �—
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ 1-2
5. Plumbing Fixtures: Water Closets Urinals Lavatories_ Bathtubs_____
Showers_ Kitchen Sinks / Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank r/ D O Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum
Lt Sand,Gravel,Clay,etc.) ground water table-_ ��`
8. If not served by public water supply: Distance from Owner's well 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 Length Width Total
Other `I Wall or, Cc. 'A o �
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
1-1 ImAN 6 X h0Nd / 40 1141
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By