HomeMy WebLinkAboutSeptic Repair 80 Robert Drive 4
TOWN OF SOUTH WI N DSOR
' BUILDING DEPARTMENT
SouA Windsor, Connecticut
CA cp it
Application for Permit t it Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date 19 4 f/
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: p //
1. Owner of Property_ h� — L) I I I, Q ;1� Address] off Owner
2. Location of Property cF nd a b e ,� �^ "� Lot. No.
3. Type of Structure A.I T /Y d No. of Bedrooms
Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ Fa-
5. Plumbing Fixtures: Water Closets z Urinals y Lavatories_ Bathtubs
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank ;Z-:r-Z) 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 Length .S—l� Width_ 3,e Total I%S-d ,J1 17.0
Other
Signature,
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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DPP
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30,
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Permit Issued 19 By
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Installation Completed, Inspected and Approved 19 By is 7