HomeMy WebLinkAboutDrain Layers Permit 52 Pine Knob Drive TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT ,
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date 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 �I� ) ,- � r�,w Address of Owner
2. Location of Property 'S '- Lot. No. S 9"
3. Type of Structure No. of Bedrooms
Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises ,,. I
5. Plumbing Fixtures: Water Closets / Urinals Lavatories- Bathtubs
Showers_ Kitchen Sinks_ Laundry Tubs Garbage Grinder Other �<
6. Liquid Capacity of Septic Tank Gay I Material of Septic Tank__( �-
7. Soil Conditions: Type of Soil i _Maximum ground water table f
�--1 '�
(Sand,Gr vel,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, storm drain or embankment 1#
10. Percolation Tests: Time for V drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Z Width __73 Total 7 0 z"/
Other
Signatur 1CL �-.
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
i '' "i J :J..J-"'_. r..:.+y�- 0•;r,.w,71 vy� ,, . r+a-1 s'
Ilia Sol
--- - — o`
x
14
Perm Issuedr _ '
+rt �. r
Instaffi i6n1tompleted, Inspected and Approved