HomeMy WebLinkAboutSeptic Repair 7 Niederwerfer Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
pplication for Permit to Install or Repair Individual Sewage Disposal System
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Application No. 7J"/
TO THE BUILDING DEPARTMENT: Date cx l 19 ��—
A permit is requested for repair or construction of an individual sewage disposal syi y m conce ning which the
following information i;Z91,
ltted: ,J
1. Owner of Propert �/.4� V !J t/f4, oV,V Address of Owner /G�i ��� 4J eloe
2. Location of Property Lot. No. '
3. Type of Structure r V cr-
o. of Bedrooms "� ;t
(Dwellin ommercial Building,Store,e N
)
4. Number of Families or Persons to Occupy Premises_ 29
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs .
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank_G -4 Material of Septic Tank_ n �ol
7. Soil Conditions: Type of Soil Maximum ground water table_ /A4/�
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well from adjacent wells E f
9. Distance to nearest water course, drainage ditch, storm drain or embankment_ /
10. Percolation Tests: Time for 1" drop in soil test �/ysr�� - Classification of soil d•
r-- r
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches � Length / , Width f t p
Total
Other
Signature
( censed Installer)
(Sketch showing all minimum distances and other details required below)
Z�)104
G2'
x°
61--
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By