HomeMy WebLinkAboutSeptic Repair 134 Woodland Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT ,
South Wi!n sorry Connecticut
Application for Permit to Install or Repo r Individual Sewage DisposalWy�ep
Application No.
TO THE BUILDING DEPARTMENT: DateAAt 3 , 191L
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 Address of Owner 3 f/(�Lk
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2. Location of Property f% C A Lot. No. L 3
3. Type of Structure —No. of Bedrooms 3
(Dwelling,Commercial Building,store,etc.)
O&4. Number of Families or Persons to Occupy Premises ���I L
5. Plumbing Fixtures: Water Closets Urinals "T— Lavatories _ Bathtubs_
Showers Kitchen Sinks LAundry Tubs Garbage Grinder Other ��
6. Liquid Capacity of Septic Tank'�/<0' Q 44 Material of Septic Tank���/ ¢
7. Soil Conditions: Type of Soil T11 Maximum ground water table s T/ '
(saw,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, s orm drain or embankment D C
10. Percolation Tests: Time for 1" drop in soil test ai Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length So Width Total
Other � �P41O,C U, �LaC 20
Signature
icensed 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