HomeMy WebLinkAboutSeptic Repair 00 Oakland Road (4) TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System ?�
Application No. •7
TO THE BUILDING DEPARTMENT: Date / 19 4S
A permit is requested for repair or construction of an individual se g disposa ystem concerning which the
following information is submitted:
1. Owner of Property JW111C17 �� Address of Owner /�G Ali • �• efi/ J`�'�/
�j �
2. Location of Property f eat L/E? � Lot. No.
3. Type of Structure fJ I4, mac. s �^� No. of Bedrooms T
(Dwelling,Commercial Bu ding,Store,etc.)
4. Number of Families or Persons to Occupy Premises— e
5. Plumbing Fixtures: Water Closets Urinals LavatoriesL_ Bathtubs
Showers — Kitchen Sinks — Laundry Tubs 9--- Garbage Grinder Other
6. Liquid Capacity of Septic Tank 7 ® I , Material of Septic Tank
7. Soil Conditions: Type of Soil 9/l Maximum ground water table /Z /
(Sa ,G�v�-�ravel,Clay,etc.) f
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 �� 6
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 L Length S� Width Total/J 6
Other
Signature `s '
(Licensed ller)
(Sketch showing all minimum distances and other details required below) �]
ID
� b
c f-
S7 7
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By