HomeMy WebLinkAboutSeptic Repair 73 Alison Drive (2) TOWN OF SOUTH WINDSOR
w BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install o(Repair ndividual Sewage Disposal System
Application No. j� '
TO THE BUILDING DEPARTMENT: Date. j-y�� 19
A permit is requested f repair r construction of an individual sewage disposal system cpncerning which the
following information is submitted:
1. Owner of Property 1z /� /c G�e'1� Address of Owner '7z�_
2. Location of Property tP e�2 A Lot. No.
3. Type of Structure No. of Bedrooms
1( welling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,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
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 7s\� Width /. 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 19 By
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