HomeMy WebLinkAboutSeptic Repair 339 Oakland Road r
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TOWN OF SOUTH WINDSOR ! ,err ,.,
BUILDING DEPARTMENT
South Windsor, Connecticut Z�•°i—_�� ®„
Application for Permit to Install or Repair Individual Sewage irD sposal System
Applicatio No.
TO THE BUILDING DEPARTMENT: Date 19 e-11,
A permit is requested for repair or construction of an individual sewage sposal system concerning which the
following information is submiitttt d:
1. Owner of Property {1✓r p� �f��je '.Address of Owner33?C-��
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2. Location of Property Lot. No.
3. Type of Structure Id, No. of Bedrooms
(L1welg Commercial Budding,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ S�
5. Plumbing Fixtures: Water Closets / Urinals / Lavatories / Bathtubs
Showers t Kitchen Sinks Laundry Tubs Garbage Grinder otherg
6. Liquid Capacity of Septic Tank S`v o Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(sand,Gravel,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
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 Wi
Width Total
Other /6 p
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Signature
ignure i
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
19 By
-apleted, Inspected and Approved 19 By
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