HomeMy WebLinkAboutSeptic Repair 471 Rye Street TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to 4ANEWw Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date _19 oC��
A permit is requested for repair or construction of an individual sewage sposal system concerning which the "
following information is submitted:
1. Owner of Property Address of Owner
2. Location of Property 2/ Lot. No.
3. Type of Structure No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets r2— Urinals d Lavatories 9 Bathtubs_
Showers 0 Kitchen Sinks_ ` Laundry Tubs_6 Garbage Grinder_d Other
6. Liquid Capacity of Septic Tank Material of Septic Tank
7. Soil Conditions: Type of Soil x4 t1, Maximum ground water table
(Sand,G a 1,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_ 70, ��C� y /
10. Percolation Tests: Time for 1" drop in soil test 3 t4ft� Classification of soil_
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width 3 D � Total /.rd
Other
Signatur
censedIns er)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 9i71°1%<- 19 66 By 4f Y A .