HomeMy WebLinkAboutSeptic Repair 182 Oak Street y
TOWN OF SOUTH WINDSOR ��
l! BUILDING DEPARTMEN
T
South Win r, nnecticut
Application for Permit to Install qr I pair ndividual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT• Date,� �,
A permit is requested for Ire air or construction of an individual sewage disposal system concerning which the
following information is submitted-
1. Owner of Property ,�i -�/ Address off Owner
2. Location of Property -� /� �.gfr1�a =✓ Lot. No. `7
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 !I. -—%1 4-- ,Ie Maximum ground water table
(Sand,Gravel,Clay,etc.)L
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 ., -2. Width. y � Total
Other
Signature
(i'leensed installer)
1 ! fs
(Sketch showing all minimum distances and other details required below)
zo-- ...e/
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By