HomeMy WebLinkAboutSeptic Repair 97 Woodland Drive C '
TOWN OF SOUTH- WI N DSOR
a BUILDING DEPARTMENT
South Windonnecticut
Application for Permit to Install o ( Repair/ ndividual Sewage Disposal System
Application No. �16
TO THE BUILDING DEPARTMENT: Date_ May 7, 19 64
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: 11en,y Nembreck*$
1. Owner of Property Address of Owner 97 woodland Dr.
2. Location of Property Same Lot. No.
3. Type of Structure Dwelling 3
No. of Bedrooms
(Dwelling,Commercial Build Store,
4. Number of Families or Persons to Occupy Premises_ One f ami lv
5. Plumbing Fixtures: Water Closets Urinals None Lavatories �- Bathtubs �-
Showers 1 Kitchen Sinks �- Laundry Tubs None Garbage Grinder lone Other —`
6. Liquid Capacity of Septic Tank?50 Or .900 ga•Material of Septic Tank Metal
7. Soil Conditions: Type of Soil Clay Maximum ground water table 4/5 feet
(Band,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well Public from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment StOrM sewer in gutter
10. Percolation Tests: Time for 1" drop in soil test Addition Classification of soil Clay "B"
11. Minimum square feet of effective seepage area required Addition 12. Leaching System: Number of trenches 2 Length 75/25 Width 2//
2ift• Total100 lineal
Other Concrete block cesspool, 8 ft. diam. , 4 f . block core
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Signature C
censed Installer
(Sketch showing all minimum distances and other details required below)
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Permit Isst ed 19 By
Installation Completed, Inspected and Approved ' 19 By