HomeMy WebLinkAboutSeptic Repair 00 Sullivan Avenue (5) TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System 93�
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:
1. Owner of Property /(,-d_!' <--o o L Address of Owner ,C/�nh p,
2. Location of Property Lot. No.
3. Type of Structure�O �t :�,� �fH a M , J':�.�_ No. of Bedrooms
\ welling,CommerciS Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ �d Aak
5. Plumbing Fixtures: Water Closets Urinals _ Lavatories, 4 Bathtubs
Showers Kitchen Sinks;_ Laundry Tubs_ Garbage Grinder Other
6. Liquid Capacity of Septic Tank ,1_ 9r6 0 Material of Septic Tank
7. Soil Conditions: Type of Soil S.h X, Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well/pw L.i e from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment o'l.o�• e ,
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required 2,/4
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12. Leaching System: Number of trenches �— Length Y.r Width .1_� Total :� ]0 f
Other
ZVSignature
(Lice ed nstaller)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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