HomeMy WebLinkAboutSeptic Repair 00 Sullivan Avenue (9) 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 n rning which the
following information is submitted:
1. Owner of Property_ tl Address of Owner_ oR
2. Location of Property �� � 5
Lot. No.
3. Type of Structure d�C� No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ /l r
5. Plumbing Fixtures: Water Closets Urinals Lavatories_ Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder /OOther
6. Liquid Capacity of Septic Tank >0ea 'Y-Z�0,0 a Material of Septic Tank
7. Soil Conditions: Type of Soil �P/ Z� Maximum ground water table
(Sand,Gravel,Clay,etc.)
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
10. Percolation Tests: Time for 1" drop in soil test /o,/4". Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length 4 ��'- Width Total /� f
Other 13;1
Signature
icensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
7-1
. Ns,7,-v rid ��j .SJ A.
.ro y4"l' °��r•a
b '
dT
1
I
I
I
I-N
�i
mil . .�/flJ ir��iE� -
��
��
q �
14 t
sa `
11 02
;� r
/60
v 8d�
d / ,.
>m