HomeMy WebLinkAboutSeptic Repair 141 Oak Street AAA TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Fepair
, Connecticut
Application for Permit to Install ndividual Sewage Disposal System
Applicatio No. ���
TO THE BUILDING DEPARTMENT: Date 19 is 7"
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:: -�
1. Owner of Property N E R I A M-'P X BELL Address of Owner / �
(7� 11 i� J
2. Location of Property Ph
,"[ Grr Lot. No. 3 Q
3. Type of Structure Il LtJ C L L I IV No. of Bedrooms
(Dwelling,Commercial Building,Store,,etc.) f�
4. Number of Families or Persons to Occupy Premises 0 fit ,�(I I— T '�'' 1#�,60 P L
5. Plumbing Fixtures: Water Closets n gg Urinals "'^" Lavatories Bathtubs_
Showers Kitchen Sinks _ Lauirdry ubs �� Garbage Grinder Other
6. Liquid Capacity of Septic Tank � �,rff (.C! L' Material of Septic Tank �! /fL
7. Soil Conditions: Type of Soil�/t / Maximum ground water table '
(Sand,Uravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well /i 8 L1 G from adjacent wells
8.. Distance to nearest water course, drainage ditch, storm drain or embankment Q AIC—
10. Percolation Tests: Time for 1" drop in soil test/1 E 9 Al Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches ` Length Wid FIT Total L AI-
?g,V5 Other Coe E R La e C9T s' P 0c L fl' ) r
Signature Se' z7
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(Sketch showing all minimum distances and other details r uiw wow�M V F/I
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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