HomeMy WebLinkAboutSeptic Repair 00 Strong Road (3) 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: Date. o(1/1 /419jk�
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: A ,�
1. Owner of Property C b %Q h 4 6'l/ C e 1 Address of Owner /Yfec��h 6✓�f- � c�
2. Location of Property D o CL 4
�� Lot. No.-
3. Type of Structure .owe- 11 Yg No. of Bedrooms_
(Dwelling,Commercial UUilding,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank `,-,) Material of Septic Tank cc )V G J'e:A--
7. Soil Conditions: Type of Soil Q5-"/-7- �A l,/C - Maximum ground water table �O/✓�
(Sand,Gravel,Clay,etc.) f
8. If not served by public water supply: Distance from Owner's well from adjacent wells 7^��
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 required
12. Leaching System: Number of trenches Length Width `l //; Total
Other
Signature 4U4.¢07-v
(License Installer)
(Sketch showing all minimum distances and other details required o )
_Permit Issued 19 By
�tallation Completed,Inspected and Approved 19 By
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