HomeMy WebLinkAboutSeptic New 3 Alpine Drive 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 tl,p f- 1 I 19_(29_
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Propertyt{y�US i YL�- Address of Owner 7rn A n)C/.,NeP R
2. Location of Property( +, V') [ -&l✓*. Lot. No.�_�
3. Type of Structure -al F 1, I yo (fit No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_.
5. Plumbing Fixtures: Water Closets vZ Urinals Lavatories_ Bathtubs
Showers_ Kitchen Sinks I Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank /c2_'i0 Material of Septic Tank
Soil Conditions: Type of Soil p Maximum ground water table
7. So Co yp A'rZD PAC ��A ni"i1
(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 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required i j 0 6 1/
12. Leaching System: Number of trenches Length '� Width Total a 0
Other
Signat
(LicensedZirr
(Sketch showing all minimum distances and other detailsbelow)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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LOT }16 ?, "BIRCH HILL ESTSTES", SECTION #7
TOWN OF SOUTH WINDSOR. CONNECTICUT
SCALE: 1" 4o ,
�..�• L.S. #4395 I
Rookville, Conn.
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