HomeMy WebLinkAboutSeptic Repair 219 Oak Street TOWN OF SOUTH WINDSOR �z6y
BUILDING DEPARTMENT LX
South Wind"— necticut
Application for Permit to Install or epair ndividual Sewage Disposal System
Application 1No.
TO THE BUILDING DEPARTMENT: Dat�c.-t' .--1 ig�
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
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1. Owner of Property,- �� �, Address of Owner .4
2. Location of Property 'C---1 ot. No. -7 4-
3. Type of Structure_. W -e-)( J'^d No. of Bedrooms_
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises c�so c
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5. Plumbing Fixtures: Water Closets Urinals Lavatories-2 Bathtubs _
Showers_ Kitchen Sinks Laundry Tubs------ Garbage Grinder------ OtherAQ-- ,,-
6. Liquid Capacity of Septic Tank ` O0 C-) G z Material of Septic Tank r"" -1-
7. Soil Conditions: Type of Soil I Maximum ground water table_ 9 DU
-
(Sand,I
avel,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 7 O 4 r e,T
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 Width .3C ` Total
Other
Signatur
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved oZ S[ ro a E2 196(o_ By •
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