HomeMy WebLinkAboutSeptic New 817 Pleasant Valley Road TOWN Of SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System,
Application No.
TO THE BUILDING DEPARTMENT: Date. Z 19
�*, 6
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 0 Addre s of Owner / �� (/a P
2. Location of Property , z e Lot. No.
/
3. Type of Structure No. of Bedrooms_
(Dwelling,Col ercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets �2 — Urinals Lavatories` Bathtubs_
Showers Kitchen Sinks_ _ Laundry Tubs Garbage Grinder_ Other
/J
_o� _ �
6. Liquid Capacity of Septic Tank.. �D Material of Septic Tank <.� �e/ r ry w
7. Soil Conditions: Type of Soil c !n<V�"� Maximum ground water table__ ®vow
(Band,Gravel,Clay,etc.)
8. If not served b G
y public water supply: Distance from Owner's well �U � � 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 Classifi ation of soil
11, Minimum square feet of effective seepage area required 13
12. Leaching System: Number, of trenches Length Width a Total 7 Z
Other
Signature
(Licensedlnstaller)
(Sketch showing all minimum distances and other details require'ow)
6
117
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
1 _ ,
•'`A,F SJ / it .[,a `J' �.� •�^ ;,� �" ,fiI '•,. �.. �� ,,�...6!T, ��` �C..^f %`/ `f //✓//' ) .t� ..'` ....� i�.j ti..�(,�7/��''�d )' ..
f f''
7
•/'`'mil-f i
f r
i
A +