HomeMy WebLinkAboutSeptic New 7 Apple Tree Lane TOWN OF SOUTH WI N DSOR
BUTLDV. C. DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal
/lSystem
Applicati`n No, 7®��
TO THE BUILDING DEPARTMENT: Dat 19
A permit is requested for repair or construction of an individual sewage dispos system concerning which the
following information is submitted:
1. Owner of Property L-a n/t h d Address of Owner, 7 s
2. Location of Property Lot. No.
3. Type of Structure No. of Bedrooms 3
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ 6
5. Plumbing Fixtures: Water Closets 1 Urinals Lavatories I Bathtubs
Showers I Kitchen Sinks Laundry Tubs' Garbage Grinder 27 -^t Other
6. Liquid Capacity of Septic Tank f`D O Material of Septic Tank_ Ca— — el?R 0 to
7. Soil Conditions: Type of Soil ORA Pyn Maximum ground water table_
(Sand, ra el,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 soilc.��
11. Minimum square feet of effective seepage area required
A
12. Leaching System: Number of trenches Length Width v200_ Total &i—
Other
Signature
(IAcensed Installer)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 08 H4 19 L' By
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