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HomeMy WebLinkAboutSeptic Repair 15 Pine Tree Lane TOWN OF SOUTH WI N DSOR BUILDING DEPARTMENT©,c) South Winotsqr, Connecticut '' Application for Permit to Install or It' , p it Individual Sewage Disposal System Application No. TO THE BUILDING DEPARTMENT: Date-Aot K 1914 A permit is requested for repair or construction of an individual sewage disposal sys tem concerning which the following information is submitted: ,� 40 1. Owner of Property ._.'� ��.�l�C� Address of Owner ! / �, /.j e " . 2. Location of Property Lot. No. `711"' 3. Type of Structure t No. of Bedrooms_ (�Dwe ling,Commercnial Building,Store,etc.) 4. Number of Families or Persons to Occupy Premises_ Il IL 5. Plumbing Fixtures: Water Closets z Urinals Lavatories lBathtubs Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other�6 � 6. Liquid Capacity of Septic Tank AL 0 Material of Septic Tank — 7. Soil Conditions: Type of Soil � Maximum ground water table 6 1�-/`, (Sa d,Grave,C y, c. 8. If not served by public water supply: Distance from Owner's well from adjacent wells ^---� 9. Distance to nearest water course, drainage ditch, st rm_drain or embankment 10. Percolation Tests: Time for 1" drop in soil test Classification of soil_j4j,/4Q 11. Minimum square feet of effective seepage area required � 12. Leaching System: Number of trenchest�,p'Pr—� Length Width Total' IV Other L. 41 4t 3 Signature � -M icensed Installer) G� (Sketch showing all minimum distances and other details required below) P/ Z/1�? o 34 Permit Issued 19 By Installation Completed, Inspected and Approved 19 By .. .. _ ,� ,. e � ., �. I 1 I 1 1 _, Cam""�.�lA/'� � � �� � .� � � �!�DiAP7t ��,------ ----- —�r—'/ ORlGin/AL+ F/E,�7� � � a #�S— InIC /2C� �An/� TOWN OF SOUTH WI N DSOR '' mac BUILDING DEPARTMENT South Windsor, Connecticut Application for Permit to Install or Repair Individual Sewage Disposal System Application No. TO THE BUILDING DEPARTMENT: Date Vat if19 7• 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 � Address of Owner, 2. Location of Property //� �•<dr-� //r'e e C-v • Lot. No. 3. Type of Structure gjtV l- r, .iy L No. of Bedrooms (Dwelling,Commercial Building,Store,etc.) 4. Number of Families or Persons to Occupy Premises_ 4-;, ✓�,- 5. Plumbing Fixtures: Water Closets /� Urinals l Lavatories Bathtubs Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Other 6 Liquid Capacity of Septic Tank Material of Septic Tank 7. Soil Conditions: Type of Soil A� /N Maximum ground water table CSAnd,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 4K4&z ' T�' Signatu (Licensed Installer) 10, (Sketch showing all minimum distances and other details required below) Permit Issued 19 By Installation Completed, Inspected and Approved 19 By.