HomeMy WebLinkAboutSeptic Repair 63 Robert Drive c
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENIT
South Windsor, Connecticut
plication for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date 1-5—1& 19 4�
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
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1. Owner of Proper- Address of Owner_ �� ..-
2. Location of Property Lot. No.
3. Type of Structure '6�p , No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ �-e
5. Plumbing Fixtures: Water Closets Urinals_ Lavatories Bathtubs
Showers Kitchen Sinks_ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank. Material of Septic Tank L�l
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gr el,Clay,etc.) /
8. If not served by public water supply: Distance from Owner's well from adjacent wells 00*-"/�
9. Distance to nearest water course, drainage ditch, storm drain or embankment � C�.,o(-:r�
10. Percolation Tests: Time for 1" drop in soil test e� Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number, of trenches�� _ Length Z s dth z��- / Total p-
Other
\\ Signature
"fucdhsed Installer)
1
(Sketch showing all minimum distances and at details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19__,r__ By