HomeMy WebLinkAboutSeptic Repair 510 Nevers Road � p TOWN OF SOUTH WI N DSOR
�� " A�� BUILDING DEPARTMENT AE�AIiT
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Windsor, Connecticut Ak• To-
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. 09a%70-1
TO THE BUILDING DEPARTMENT: Date_i- SE/�Tf N 19 At
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property4840*41'6440) NgMQI/K/t Address of Owner S3 C4.F4M/INf fli�ulT�als
2. Location of Property •SZO A1~A6 4**,b Lot. No.
3. Type of Structure b«orsa "! No. of Bedrooms_
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises OKi 4t)
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 1006 &AjA.&IJ Material of Septic Tank 0 o eAFre
7. Soil Conditions: Type of Soil SAA/A # CRA✓Ec. Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's wellMW f 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 b rwtNulEf Classification of soil
11. Minimum square feet of effective seepage area required,0 10 Ofr AM A&AbA" TIV104, Oi 41111.0 t4 �
12. Leaching System: Number of trenches7N/4015"L3) Length at$o Ft Width FT Total 6a5'Sq Ar
Other
Signatur •
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AN�er ��ii�9• �i�,
(Sketch showing all mini�llum distances and oAt et ds require e�w�
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Permit Issued AS SOPMA0044 19� ByROL IC4W4AOS Zit
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Installation Completed, Inspected and Approved of ®crog,46;C 19Z_ •eca� .[a,
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