HomeMy WebLinkAboutSeptic Repair 209 Oak Street TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date .T,—. - - 19 G&
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 04/S pe /L� ( //%�� Address of Owner ,9�E�,S t S j 11q/V,
2. Location of Property �g ot. No. 7 7
3. Type of Structure $26&Z _ L L /A/
No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ l J
5. Plumbing Fixtures: Water Closets Urinals Lavatories / Bathtubs /
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other aw &)w �4/,�c r
6. Liquid Capacity of Septic Tank Material of Septic Tank
7. Soil Conditions: Type of Soil_ —
(Sand,-Gravel,Clay,etc. Maximum ground water table_ — —
o�/ (zj�74
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 Width Total
Other ,fG/.X/ a4,�7,x z
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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