HomeMy WebLinkAbout214 Long Hill Road - Septic Application1W
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jg L/a TOWN OF SOUTH WINDSOR
ye BUILD‘lN'G:DEPARTMENT
%‘‘2 ‘>KW South Windsor,Connecticut
{phcahon for Permit to Install or Repair Indmdual Sewage Disposal Systgm
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Application No.f;w
TO THE BUILDING DEPARTMENT:Date 19
A permlt 1s requested for repair or construction of an individual sewage disposal system concerning which the
followmg mformatlon ls submitted
1.
2.
Owner of Property #gplwgO ELLEA ga€££ddress of Owner ,?/¢[CIL/a”%¢L /Q;/
Location of Property 724701 é”Lot.No.
Type of Structure 0 Lo LLLIIV No.of Bedrooms i5;
Number of Famllles or Persons to Occupy Premlses /‘//M’g%/71/L i/0096J’K’IC/J"
Plumbing Fixtures:Water Closets l Urmals m.—Lavatories z Bathtubs Z
Showers z Kitchen Sinks l iaundry Tubs V‘Garbage Grlnder i"Otherg @[z@é w&/£$7'
$-€aterlal of Septic TankKéli/L/é é'fé'/w//{//2g(/j )
X/{Maximum ground water table (g f7
(Dwelling,Commermal Burldmg Store etc )
If not served by public water supply:
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Distance
Gravel,
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Clay,
ifromzOwner’s,_etc.)
V Well 2,5 x/f7
from adJacent wells /5 /
6/
K/
Liquid Capacity of Septic Tan k
Soil Conditions:Type of Soil
Distance to nearest water course,drainage ditch,storm drain or embankment 4/§A/é?
Percolation Tests:Time for 1"drop in soil test “—"""—”Class1ficat10n of soil ('2 Z w/f 72 fi/
Minlmum square feet of effective seepage area required //«1/1/77 K #:J I
Leaching System Number of trenches Length g;M i
Wldth é é g Total Zgg jk‘
OtherC‘aL/r Ken?gLc/Ckcefs 2a“t Bwr K’r?g1?y
(Licensed Installer
10.
11.
12.
Signatu
(Sketch showing all minimum distances and other details required below)
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Law/6'[7V4 41.rd
Permit Issued 19 By
Installation Completed,Inspected and Approve 19 Byd
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