HomeMy WebLinkAboutSeptic Repair 30 Valley View Drive � 4
TOWN OF SOUTH W1 N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System-;�1'0
Application No.
TO THE BUILDING DEPARTMENT: Date _ -67 19
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A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitt ✓p1� /Q Ea /�
1. Owner of Property f Address of Owner, -- te
2. Location of Property 3o �—F' Lot. No. 49
3. Type of Structure No. of Bedrooms
(Dwelling, o ercial Building,Store,etc.)
4. Number of Families or ersons to Occupy remises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs f
Showers_L_ Kitchen Sinks Laundry Tubs I Garbage Grinder Other
6. Liquid Capacity of Septic Tank / 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 -
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 7.S r Widt V Total '7 s
Other
Signature
(Licensed 1 sta er)
(Sketch showing all minimum distances and other details required below)
1
`rmit Issued 19 By
�allation Completed, Inspected and Approved 19 By
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�-- `: FOR BUILDING PURPOSES ONLY '