HomeMy WebLinkAboutSeptic New 00 Pierce Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date '.Z S Tu e4 e 19k9
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 foNW�, r�A.6tp•JSK/ Address of Owner
2. Location of Property_ Lot. No.
3. Type of Structure 814/,LD 0421: Cg drJA No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder/_ Other
6. Liquid Capacity of Septic Tank 12"no Material of Septic Tani0ey Mg-rS— ofc�wJ,pe�,
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,Clay,etc.)
0
8. If not served by public water supply: Distance from Owner's well 77 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 Al Nut£$ Classification of soil
11. Minimum square feet of effective seepage area required 4106
12. Leaching System: Number of trenches'Sr,~ Length Width 31/ !! Total 4l48
Other
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Signature
tensed Installer)
(Sketch showing all n minimum distances and other details required below)
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Permit Issued_ o?SV:2 4E 19-0— B
Installation Completed, Inspected and Approved e?AZ _�u�Z 19_(p 9 By
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