HomeMy WebLinkAboutSeptic Repair 00 Ferry Lane Q,
1 1 TOWN OF SOUTH WI N DSOR
b, Q BUILDING DEPARTMENT
#d6
�p l South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date_
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of PropertYN& 44ft c�q�e`: Address of Owner
2. Location of Property Sio e r c/ 11 a
/� f Lot. No.
3. Type of Structure OW e No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
el
4. Number of Families or Persons to Occupy Premises_ F., Ae
5. Plumbing Fixtures: Water Closets _ Urinals _ Lavatories— Bathtubs_
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Cl Other
6. Liquid Capacity of Septic Tank Material of Septic Tank C e'�c
7. Soil Conditions: Type of Soil P44!9( Maximum ground water table =
(Band,Gravel,Clay,etc.)
8. If not seryed,by
public water supply: Distance from Owner's well from adjacent wells _Z_�Old
9. Distance to nearest water course, drainage ditch, storm drain or embankment 71- /Q 0
r.:
10. Percolation Tests: Time for 1" drop in soil test 2 /ti/ Classification of soil._ 4
' 11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches ._ Length 6 Width _3 0 �� Tota1,30e;, 1.1
Other
Signature a..,.
(Licensed installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: g
1. Owner of Property& 1 wd al Address of Owne01
r
2. Location of Property A e' <°s!
`4 Lot. No,
3. Type of Structure_ +iVG4 ,i:!f a ear No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises .3 �er
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs_
Showers_ Kitchen Sinks_ Laundry Tubs_ Garbage Grinder f"1 Ot�h+er__ 0
6. Liquid Capacity of Septic Tank:./�_j) Material of Septic Tan kC de•c°n e r► e
7. Soil Conditions: Type of Soil_ Maximum ground water table "w°'
S n ,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well from adjacent wells 4��_
9. Distance to nearest water course, drainage ditch, storm drain or embankment 7 /04
10. Percolation Tests: Time for V drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches_ Length 6Q' Width__3-f Total„300 X 3s
Other
Signature,
(Licensed nst
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
�tallation Completed, Inspected and Approved 19 By
,mil. •. I� � V
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