HomeMy WebLinkAboutSeptic Repair 00 Nutmeg Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date. Cc?/, 7'; 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted
�%,j G�
1. Owner of Property ��• � �/✓Address of Owner 3 32 y/
2. Location of Property Lot. No.
3. Type of Structure Ci 0 h `n iF,Q No. of Bedrooms—
(Dwelling,commercial Building,Store,etc.)
4. Number of Vamfiies or Persons to Occupy Premises_hC v — " /,�cX S
5. Plumbing Fixtures: vte Closets Urinals / Lavatories l/ Bathtubs
Showers -- n Sinks y Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank o d Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table__
(S nd,Gravel,clay,etc.)
8. If not served by public water supply: Distance from Owner's well 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 f/.__X .41A�7 Classification of soil cF` X e!2e e %
11. Minimum square feet of effective seepage area required 's, �i�/�iic 7
12. Leaching System: Number of trenches /c, Length 2 —a Width Total 72-0 - O
Other
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
ee
l
r•
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By