HomeMy WebLinkAboutDrain Layers Permit 75 Pine Knob Drive (2) h
TOWN OF SOUTH WI.NDSORyD�°� rI
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal Syste
Application No. /SDG�
TO THE BUILDING DEPARTMENT: Date u� '�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� �.,c ..c�� i,�e'�11d.1t Address of Owner. 'S .-�ca�
2. Location of Property Lot. No. �P
Y 3. Type of Structure Y No. of Bedrooms
(Dwelling,Commercial Building$Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets/ t Urinals T Lavatories 1 thtubs_
Showers Kitchen Sinks s Laundry1 Tubs .Garbage Grinder Other
6. Liquid Capacity of Septic Tan Material of Septic Tank...42A
7. Soil Conditions: Type of Soil (Sand, vela Clay,etc.) Maxirilm ground water table�.�
,
8. If not served by public water supply: Distance from Owner's well T—' from,adjacent wells �''
9. Distance to nearest water course, drainage ditch, storm drain or embankment '� T
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 _'3 ~ Total
Other
Signatur
(Licensed Installer),
(Sketch showing all minimum distances and other details required below)',,
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Permit Issued 19 B
Installation Completed, Inspected and Approved_-. O/ vu, 19 ry 4O By