HomeMy WebLinkAboutSeptic Repair 42 Woodland Drive /*4f�
TOWN OF SOUTH WI N DSOR
k)o BUILDING DEPARTMENT �f
South Windsor, Connecticut
Application for P�ermi to Install or Repair Individual Sewage Disposal System
POQ-Y '�/1 �/�� Applicati No.—
TO THE BUING DEPARTMENT: Date / a2 19 `
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 Coact(- Addres � t�if d s of owner �
2. Location of Property Lot. No. S
3. Type of Structure r !
( welling,Commerci Building,Store,etc.) No. of Bedrooms,_
4. Number of Families or Person to Occupy Premises_
5. Plumbing Fixtures: Water Clo ets Urinals vatories Bathtubs
Showers, Kitchen Sink Laundry Tubs rbag Grinder Other
6. Liquid Capacity of Sept' ank Material of Septic Tank
7. Soil Conditions: Type of Soil �L Maximum ground water table
031na,Gravel,C y,etc.)
8. If not served by public water supply: Distance from Owner's well from as jacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment_
10. Percolation Tests: Time for V dropin soil tes "c(�L
Iassification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches L ngth Widt Total
Other t
Signature
(Lice a nataller)
(Sketch showing all minimum distances and other details required below)
fipk PIX Oil
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By