HomeMy WebLinkAboutSeptic Repair 24 Scantic Meadow Road QP49 TOWN OF SOUTH WINDSOR PAFx
,gyp BUILDING DEPARTMENTv
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
ApplicatiCr o._/
TO THE BUILDING DEPARTMENT: Date [ L-- 19 <l1
A permit is requested for repair or construction of an individual sewage disposal stem concerning which the
following information is submitted:
1. Owner of Property Q u u-- Address of Owner C �(l��G �/��/ '
2. Location of Property C Lot. No. -
3. Type of Structure p Ll1 L-.�l Fa No. of Bedrooms 3
(Dwelling,Commercial BuIlAng,cSttore,etc.)
4. Number of Families or Persons to Occupy Premises1? KE f
5. Plumbing Fixtures: Water Closet 62t= Urinals 4r— Lavatories Bathtubs
4 J y
Showers Kitchen Sinks L u adry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank i Material of Septic Tank
7. Soil Conditions: Type of Soil Ac LkY Maximum ground water table '
(band,Gr vel,Clay,-etc.)
8. If not served by public water supply: Distance from Owner's well L from adjacent wells
9. Distance to nearest water course, drainage ditch, storm
or sin a bankment
10. Percolation Tests: Time for 1" drop in soil test g Cl assi ation of soil
11. Minimum square feet of effective sgepage area required -
67_ 1 43
12. Leaching System: Number trenches Length Width Total 0
Other
C v C , 7—
s
Signature
44c,n, nstaller)
(Sketch showing all minimum distances and other details required below)
C dud
40
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Permit ssuecl A 19�v By AgVIN EDwAay.s .Ta.
Installation Completed, Inspected and Approved /S JR/n _19 990 By /yEi VIA/ 60...►Awbs J.e
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