HomeMy WebLinkAboutSeptic Repair 16 Ravine 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. l6rz4
TO THE BUILDING DEPARTMENT: Date_H a � S- 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: ) /
1. Owner of PropertyA_-:z7J iY di c,_Address of Owner
2: Location of Property_Z.4 ,tea,.i ,- T) Lot. No.
3. Type of Structure Z),,15 12,He No. of Bedrooms_
( we ,Commercial B ilding,Store,"etc.)
4. Number of Families or Persons to Occupy Premises� �
5. Plumbing Fixtures: Water Closets I Urinals Lavatories_ Bathtubs
Showers_ Kitchen Sinks ___ Laundry Tubs Garbage Grinder Other U-4a &LO S�
6. Liquid Capacity of Septic Tank O Material of Septic Tankbga e,, � � �� -
7. Soil Conditions: Type of Soil o Maximum ground water table _ - ,
and,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
.R 12. Leaching System: Number of trenches Length Width Total /
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Other
Signatur
&(;I�Mn.�edInataller)
3 .6
(Sketch showing all minimum distances and other details required below)
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Pit
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Permit Issued 19 By t;
Installation Completed, Inspected and Approved 09 j ode v By z,f�:
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