HomeMy WebLinkAboutSeptic Repair 55 Robert Drive 7
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Ins# r Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date .l?)�^/
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 w11I �e Q� Address of Ownerpr-
2. Location of Property ems,n r' Lot. No.
3. Type of Structure A)1r/ c,l� / R No. of Bedrooms '9
(Dwelling, ornmercial 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 71-Ir4 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 ,.`3 Length S D Width_ J o Total 41rA 3d
Other
Signatur
(Licensed Installer)
(Sketch showing all minitnum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By 111047