HomeMy WebLinkAboutSeptic Repair 770 Sullivan Avenue TOWN OF SOUTH WINDSOR P����T
BUILDING DEPARTMENT
by South Windsor, Connecticut A/10. 70-7®
Application for Permit to Install o(iepair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date OZ J /1T wa/1s/J 19Z
A permit is requested fo repair r construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Propertyd!q LsaA4TA Address of Own Suu.i
2. Location of Property SA07a- Lot. No.
3. Type of Structure ST00.6—r No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water .Closets `T W I-A: Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs _ Garbage Qrinder Other
6. Liquid Capacity of Septic Tan ( r1 Material of)Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well from adjacent wells
i -
9. Distance to nearest water course, drainage ditch, stortm-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-r►+P2.EG C3) Length l55 FT Width a. FT Total 38854 &-r
Other
Signature,,(Q� � ff
(Sketch showing all mini�m,um distances and otber��e its requi�ed �ow�� Cl`'�
S<FE o�S�+R. FDJL s�t�te k�s
Permit Issued 42 S6PT4KbE2 19-71-0 By A4eL ACDcclAt all .Tit-.
If
Installation Completed,Inspected and Approved &4 SPpxiakE,grit, 19 7O
Z'7o S�L�.t✓An('
s .A
SePf�cTAnI�L 53�1
O EXP tsG I*. .
e 6FArl oxr
3o' t \
i
6 of
t
6��