HomeMy WebLinkAboutSeptic Repair 9 Sunnyside Drive d
TOWN OF SOUTH WINDS6k
BUILDING DEPARTMENT
South Win Connecticut
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Application for Permit to Install ai epair Individual Sewage Disposal System
s Application No. >
TO THE BUILDING DEPARTMENT: Date Z 19 6
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 Address of Owner /1-11 r C .S +V 1
2. Location of Property 9 Sa.,a,stlb �atr�. Lot. No. I 2
3. Type of Structure w i
(Dwe ing,Co ercial Building,Store,etc.) No. of Bedrooms
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 1 2 Material of Septic Tank__GYI:-r e �
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
9. Distance to nearest water course, drainage ditch, storlr} drain or embankment
10. Percolation Tests: Time for V drop in soil test f'Yi s nl Cl ssifi�ation of soil
11. Minimum square feet of effective seepage area required o� 0/
12. Leaching System: Number of trenches_ Length 17 6 _ Width---- I Total "
Other
Signature r%
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(Licensed Installer)
(Sketch showing all minimum distances and other details required ow)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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Sep ere; er 1 �3 1 AID Rockville, Song,
• TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal SystemG
-oil/? S. 0ar avW er— Application No.
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TO THE BUILDING DEPARTMENT: Date G 19 U
A permit is requested for repair or constru ion of an individual sewage disposal sy em concerning which the
following information is submitted:
1. Owner of Property Address of Owner.Z�_2/VC
2. Location of Property ,tee SUMV IAL �l d g_ Lot. No.
3. Type of Structure Q ,/V No. of Bedrooms
(Dwe ling, ommercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories_ Bathtubs_
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 2 X Material of Septic Tank r 0 h c_V, e u
7. Soil Conditions: Type of Soil �e�edMaximum ground water table
(Sind, avel,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 /77_/10V Classification of soil
11. Minimum square feet of effective seepage area required 6 G /�
12. Leaching System: Number of trenches 1..� Length Widt Z i2 Total 076 V
Other ,°,��,
Signatur
(Licensed Installe
(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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