HomeMy WebLinkAboutSeptic New 34 Barber Hill Road I _
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TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System��3
Applicatio No.
TO THE BUILDING DEPARTMENT: Date 19
sposal system A permit is requested for repair or construction of an individual sewage concerning which the
following information is submitted:
1. Owner of Property �!�'hcJ Address of Owner
2. Location of Property Lot. No.
3. Type of Structure No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ ' Gr72
5. Plumbing Fixtures: Water Closets Urinal a Lavatories_ Bathtubs
Showers Kitchen Sinks_ Laundry Tubs + Garbage Grinder�9_ Other O
6. Liquid Capacity of Septic Tank Q M,@ ial of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,Clay,etc.) t
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 i
10. Percolation Tests: Time for 1" drop in soil test.__ l Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches_ Length Width_ 1/p Total
Other A >
Signatur/erdetails
nsed Installer)
(Sketch showing all minimum distances and required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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NOTES SOUTH WINDSOR HEALTH DEPARTMENT
LOCATION //%//
1noi- ^� sc r OWNER 14jollim
TYPE OF WORK
DATE 3-31-fr PE IT PIPE
INSTALLER o %i, Cu r
INSPECTOR DRAWN BY