HomeMy WebLinkAboutSeptic Repair 136 Robert Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System!
Application No.
TO THE BUILDING DEPARTMENT:
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 eR Address of OwnerT-E, C80/2
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2. Location of Property_ J f/T� Lot. No.
3. Type of Structure f!IV 6�d ///c No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises L1E !2AI t
5. Plumbing Fixtures: Water Closets Urinals Lavatories�� Bathtu�b`s/� _
Showers Kitchen Sinks4�undry Tubs --" Garbage Grinder `-' Other �� /TJ �/C
6. Liquid Capacity of Septic Tank ' � CIL ` (-Material of Septic Tank G '�
7. Soil Coftditions: Type of Soil.eLi � i'Ml a& � Maximum ground water table ;4&& ,
(Sand,x-,$(eei lay,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 r 'n or erhbankment
10. Percolation Tests: Time for 1" drop in soil test ' _Classification of soil
11. Minimum square feet of effective seepage area required d�✓
12. Leaching System: Number of trenchest_ Length/00 Width .1 dt 'Total
Other IcAekt(.' tr#
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Signature kol
( censed Instal er)
(Sketch showing all minimum distances and other details required below)
C u►'�LE
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Permit Issued 19 By
Installation.Completed, Inspected and Approved 19 By