HomeMy WebLinkAboutSeptic New 00 Sullivan Avenue 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
A permit is requested for repair or construction of an individual sewage disposal system concerning_whh
ich the
following information is submitted
1. Owner of Property tip , f
-T —�-a.-t•�-� Address of Owner-25" h,
A
2. Location of Property_
�J Lot. No.
3. Type of Structure_(,,,,/�A /1� lu1 p r/C
(DWelling,Commercial Building,Store,etc.) No. of Bedrooms_
4. Number of Families or Persons to Occupy Premises_.a
5. Plumbing Fixtures: Water Closets_ Urinals_ 10 _
Lavatories_ Bathtubs�,_V _
Showers_ Kitchen Sinks----(k- Laundry Tubs_ Garbage Grinder_ Other_
6. Liquid Capacity of Septic Tank 2,6 p Material of Septic Tank
7. Soil Conditions: Type of Soil_
(Sa d, ra el,c�'- lay,etc,) Maximum ground water table ..
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�d ® /
10. Percolation Tests: Time for 1" drop in soil test_ �—
---T�/-�l M Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches--__— Length / /�_. Widt Total_
Other
Signature
(Licensed taller
(Sketch showing all minimum distances and other details required below)
7�7
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By