HomeMy WebLinkAboutSeptic Repair 447 Nevers Road V
TOWN OF SOUTH WINDSOR
,OBUILDING DEPARTMENT
South Windsor, Connecticut
Appl cation for Permit to Install or Repair Individual Sewage, Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date 19
A permit is requested for repair or construction of an individual sewage did sal system concerning which the
following information is submitte
1. Owner of Property Address of Owner__ T�L7-r, �•-
2. Location of Property Lot. No.
3. Type of Structure No. of Bedrooms
(Dwe ,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories_ Bathtubs_
Showers Kitchen Sinks Laundry/Tubs Garbage Grinder O er
6. Liquid Capacity of Septic Tank 7 5`� -+ Material of Septic Tank ..d �
7. Soil Conditions: Type of Soil ��'�J -v - Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well �S 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 o trenches L gth Width 2 r Total ��
Other
Signatur 14
(Licensed Ins er)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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