HomeMy WebLinkAboutSeptic Repair 127 Robert Drive TOWN OF SOUTH WI N DSOR
PWe "PA tD BUILDING DEPARTMENT Pi
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�lirefi nl'), 3,114 South Windsor, Connecticut T(0,7, --g��
Application for Permit to Install or Re ai Individual Sewage Disposal System
Application No. Iool70-3
TO THE BUILDING DEPARTMENT: Da- 19_ ,
A permit is requested for epair r construction of an individual sewage disposal system concerning which the
following information is submitted: ,
1. Owner of Property Cb&gAA-J1 Address of Owner/2r7 2odeAT -:P2iye
2. Location of Property 84M€ Lot. No.
3. Type of Structure b w,6-4-f,J4 No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises Qdt Cly FRHtfu/
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank.EX'1 S 7'1 M G 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'7.S GT + 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 requiredofJfi'- CA) 10Xt01l5- -botYu,grLL
12. Leaching System: Number of trenches Length Width Total
Other E cS 6- s s I'r
Signature f(LibeEffied
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�b! ,✓"� P N� Jim C i,09�-.3.V.27118)
(Sketch showing all minimum distances and other etas s required �ow)
Sa-e- oJ�r �or sl2e�c�.
Permit Issued 01 06ToBE2 19-7-6 B
Installation Completed, Inspected and Approved 03 61-3n2o 1970 B,;2 -
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