HomeMy WebLinkAboutSeptic Repair 354 Niederwerfer Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Appl' 'on No.
TO THE BUILDING DEPARTMENT: Date 19 -,5—
A permit is requested for repair or construction of an individual sewage disposal system concerningg which the
following information is submitted: you r�J�i✓pSa/�
1. Owner of Property Ai-a n k N redP rwe rf r Address of Owner 3 s# N e d Q 1W e 4e 1:: d•
2. Location of Property /y i ecle r L. a r'7 e r `1eot . Lot. No.
3. Type of Structure i I ,^� No. of Bedrooms 3
(Dwelling,Commercial Building,Store,etc.)
• 4. Number of 84mUies or Persons to Occupy Premises_to
5. Plumbing Fixtures: Water Closets Urinals Lavatories 2_ Bathtubs /
Showers Kitchen Sinks / Laundry Tubs_ Garbage Grinder _Other
6. Liquid Capacity of Septic Tank j�..3� Material -of Septic Tank ( i 0,R r-7-E—
*R 7.,% Soil Conditions: Type of Soil Maximum'ground water table d
(Band,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well from adjacent wells 7
9. Distance to nearest water course, drainage ditch, storm drain or embankment O
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
Signature T
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved ��i�/3 E� 196 By
OP
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PERT"IT PLAN
LAND OF FR;INK AND ALICE L. NIED3RWERFER `
TOWN OF SOUTH WI NDSOR, CONNECTICUT 6Q No. 4395 ','/, ♦i,, /,
SCALE: 1 - 100 y BISTEREO I,ow
L.S. 4395
December 6, 1905 Rockville, Conn.
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