HomeMy WebLinkAboutSeptic Repair 359 Oakland Road r TOWN OF SOUTH WI N DSOR --
BUILDING DEPARTMENT
South Windsor onnecticut
Application for Permit to Install L
" pai Individual Sewage Disposal System
Application No. 93i$3,(o69`/
TO THE BUILDING DEPARTMENT: Date
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of PropertykaDxjcE oseioy£e-eai® Address of Owner299 &1tLAvD�AD
2. Location of Property -SA," Lot. No.
3. Type of Structure No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_buts C 13 4"I L y
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 914mr1rAq _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 Width Total
Other&-/f G, -e —uslDg 7'2 MaM TD At- ctSI-D " &t✓ WE" uVLI&ALOcs)
Signature AMAA Li.SyJftvSKl �* 4s t-3s98/?j
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 42/0 4W 19 V9 B
Installation Completed, Inspected and Approved_ 19 4CJ By 6�eS