HomeMy WebLinkAboutSeptic New 58 Alison Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
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Appli ation No._ T` /
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 '-Do r- MCA ST O T 4/y/S Address of Owner --5w /1/%Sei✓ �i2.
2. Location of Property �g /�Zi E ,v / e, Lot. No.
3. Type of Structure � �'/�%►�®' — __ No. of Bedrooms c
(Dw 1 ing,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ 4/0
5. Plumbing Fixtures: Water Closets l Urinals Lavatories / Bathtubs
Showers — Kitchen Sinks / Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank �� Material of Septic Tank dozyGe.
7. Soil Conditions: Type of Soil 5A,. Maximum ground water table All
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well r from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or imbankment
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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 `mod idth o? Total___
Other
Signature
(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 %3 lq/a/10 N 19 C`/ By