HomeMy WebLinkAboutSeptic Inspection 92 Nevers Road 1,7 -qqqq
ATOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT dwir
'=7 South Windsor, Connecticut A16'-6 7Q
Application for Permit to nsta r Repair Individual Sewage Disposal System
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Application No.
TO THE BUILDING DEPARTMENT: Date_ eel %EPT_ *CQ 19 ZD
A permit is requested for repair o construction f an individual sewage disposal system concerning which the
following information is submitted:1. Owner of Property R OAEIlr SAM,AL14 Address of Owner
2. Location of Property 9 Z ARRAS Lot. No.
3. Type of Structure �4JFA4./NC No. of Bedrooms 3
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises dNda G) /C�A7/rCV
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank1I�f0��1 Q GAI-LOA* Material of Septic Tank dz Jc,eCri5
7. Soil Conditions: Type of Soil awVD�/•� 1;4AVEf.. Maximum ground water table
(sand,Gravol,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well's AT f from adjacent wells'"0' .
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test 1 000OUTE Classification of soil
11. Minimum square feet of effective seepage area required/.ZS Or Oat AAR"A_ " lAA.00 375ft Or
12. Leaching System: Number of trenches TWO Ea) Lengthy AT Width.7. S AgT Total 34a,S eq Fr
Other
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Signature01
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(Sketch showing all minimum distances and other details required be ow) �baTM,Qaoa
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Permit Issued cI SCrPT-yA+fe_ 19 ?6 B
Installation Completed, Inspected and Approved A-3
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