HomeMy WebLinkAboutSeptic Repair 00 Nutmeg Road (3) y� TOWN OF SOUTH WI N DSOR
� �� v BUILDING DEPARTMENT
� South Windsor, Connecticut
Application for Permit to Install o Repair dividual Sewage Disposal System 20/
Application No.
TO THE BUILDING DEPARTMENT: Date. 2
A permit is requested fo repaii construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property 131 Z Address of Owner * e, zz�/T (i- f
2. Location of Property 6Q 1:Y Lot. No.
3. Type of Structure No. of Bedrooms
(Dwelling,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 Other
6. Liquid Capacity of Septic Tank Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,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 Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length E,J�v .3 Width /n7 Total > (f
Other
Signature-..... '�
(Licensed installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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