HomeMy WebLinkAboutSeptic Repair 89 Troy Road TOWN OF SOUTH WINDSOR
%NV9. BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Applicatio/i NO. 11`a L g—
TO THE BUILDING DEPARTMENT: Date,/(1 I sZ 1 19�
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitt .
1. Owner of Property 4�-uo'l Address of Owner e Sw
2. Location of Property
�, Lot. No.
3. Type of Structure
(Dwelling,Commercial Building,Store,etc.) NO. Of Bedrooms
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories I Bathtubs P
Showers Kitchen Sinks Laundry ubs Garbage Grinder Oth r
6. Liquid Capacity of Septic Tan J—'O Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table_ f' i
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's wellfrom adjacent wells
9. Distance to nearest water course, drainage ditch, storm 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
Length Width � �' Total 3 7 S
Other
Signature 4& l ,
(Licensed I r)
µ SO (Sketch s iowing all minimum distances and ath.,IA. ci�sMr�id�re�"�owlE� �' 3�r83d
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sued ��✓EMd�2 119-0 By o
Completed, Inspected and Approved V o�rF�[�dE� 19�_ B
Y ` 011