HomeMy WebLinkAboutSeptic Repair 210 Oak Street TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENTS
South Windsor Connecticut
s
Application for Permit to Install o DRepairndividual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date 196
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 F� S 2 kr A04VDKEWAddress of Owner
2. Location of Property �j37A f!�:- Lot. No. 8 2 l 7
3. Type of Structure UZ f✓L 1—a/ G' No. of Bedrooms_
(Dwelling,Commercial
` �
Building,Store,etc.)/I /J
4. Number of Families or Persons to Occu y Premises_y
5. Plumbing Fixtures: Water Closets Urinals Lavatories`} &Bathtubs
Showers Kitchen Sinks La ry Tubs Garbage Grinder " OtheaF-fY VJR
6. Liquid Capacity of Septic Tank S!/' d PU Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sa d,Fravel,Ulay,etc.)
8. If not served by public water supply: Distance from Owner's well 4-C15"Cfrom adjacent wells
9. Distance to nearest water course, drainage ditch, stor drain or embankment t�
10. Percolation Tests: Time for 1" drop in soil test _ Classification of soil O
11. Minimum square feet of effective seepage area required �G�/
12. Leaching System: Number of trenches�� Length 0 �� Width_ Total
Other C 3��GliL Lrc� f c-r
Signatur e
(Licensed Installer) w
(Sketch showing all minimum distances and other details required below)
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06- LuwoR-�'
Permit Issued 19 By
Installation Completed, Inspected and Approved . 19 By