HomeMy WebLinkAboutDrain Layers Permit 159 Pine Knob Drive (2) T
r TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date- //
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Propertybrik:Za n ddress of Owner_/fL-7 �Tys dQ 2
2. Location of Property Z!5_!�! T: .A �!)r Lot. No.
R
3. Type of StructureDIA2 fel)/,., No. of Bedrooms_
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises
5. Plumbing Fixtures: Water Closets_ Urinals Lavatories
E �. Bathtubs
Showers_ Kitchen Sinks_ Laundry 9Tubs - Garbage Grinder - -' OtherA�
s Y
6. Liquid Capacity of Septic Tank"J D o n G v / Material of Septic Tank_C Q, —
7. Soil Conditions: Type of Soil C 1 034 Maximum ground water table
(Band,I
ravel,Clay,etc..)
8. If not served by public water supply: Distance from Owner's well om adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment .70
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 30" Total/
Other
Signat
(Licensed 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.