HomeMy WebLinkAboutSeptic Repair 481 Oakland Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT w
South Windsor, Connecticut
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Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date--, 0 Q` 1 3 , 19 69
A permit is requested for repair or construction of an individual sewage disposal system concerning which t e
following information is submitted: G,/GGaC j�j f/:a$
1. Owner of Property � KiL=4-a0 Vwddress of Owne EKI d E�- 611-1//, b IJ oZ
2. Location of Property 21 Lot. No.
3. Type of Structure_ U/A No. of Bedrooms
(Dwelling,Commercial Buildin
g
,
Store,etc.)
4. Number of Families or Persons to Occupy Premises o /F- l—A &1 L. y
5. Plumbing Fixtures: Water Closet Urinals Lavatories_ Bathtubs_
Showers_ Kitchen Sinks, Laundry Tubs Garbage Grinder Other`
6. Liquid Capacity of Septic Tank. Material of Septic TankC_
7. Soil Conditions: Type of Soil Q Chutc, Q_&Y Maximum ground water table-
(Sand,Gravel,piay,etc. f
8. If not served by public water supply: Distance from Owner's well tl from adjacent wells
9. Distance to nearest water course, drainage ditch, storm dr 'n 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 o renches _ Length -'Width ,2 Total�GFJ L/ L
Other C
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Signature
tensed InstaUe PE
(Sketch showing all minimum distances and other details required below
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By