HomeMy WebLinkAboutSeptic Repair 00 Sullivan Avenue (12) TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System f�
Application No.
TO THE BUILDING DEPARTMENT: Date_ 7 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 Property4- /&d Q( ( C c) Address of Owner 6 r 4"or.
2. Location of Property AV /�d� Lot. No.
y
3. Type of Structure �-f
(Dwelling,commercial Bui ding,store,etc.)
No. of Bedrooms
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets ,2— Urinals / Lavatories 2_ Bathtubs a
Showers_ Kitchen Sinks 0 Laundry Tubs_ Garbage Grinder_ Other C)
6. Liquid Capacity of Septic Tank. ;°Qd a Material of Septic Tank
7. Soil Conditions: Type of Soil S'.A)vh Maximum ground water table_ /
(Sand,Gravel,CjStr,etc.)
8. If not served by public water supply: Distance from Owner's welijP,0 from adjacent wells_ f 1S D
9. Distance to nearest water course, drainage ditch, storm drain or embankment d
10. Percolation Tests: Time for V drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required 7,66",G
12. Leaching System: Number of trenches— Length Width ,,'3e Total_ A�
Other
Signature
TLicenseff Installer)
(Sketch showing all minimum distances and other details required below)
fig' � b y �✓3�
—y
Permit Issued 19 By
Installation Completed,Iriisl�eeted and Approved 19 By