HomeMy WebLinkAboutSeptic Repair 00 Oakland Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Win r, Connecticut
r�
Application for Permit to Install 'r . epair ndividual Sewage Disposal System ?
Application No. //`��
TO THE BUILDING DEPARTMENT: _ Date. ` " z//, - 19
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 u rt,) Address of Owner__Z' /;r,
2. Location of Property/s (ICZ kZ 2 4-n 1_i Cl Lot. No.
3. Type of Structure _l_�6 h, AA p-t^i C
Cl3welhng,Commercial Building,Store,etc.) No. of Bedrooms
4. Number of Families or Persons to Occupy Premises_ ? t/ ,o
5. Plumbing Fixtures: Water Closets Urinals [) Lavatories. _ Bathtubs D
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank. ���d y Material of Septic Tank
7. Soil Conditions: Type of Soil Gila v c. P Maximum ground water table_r
(Sand,Gravel,Clay, .)`
8. If not served by public water supply: Distance from Owner's well y" 70 � 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 M4,<E Classification of soil f
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length 3 Width A SZ Total el,2
Other
Signature
Azl-,-
( icense nstaller)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved --rAlluA/ei 19 By