HomeMy WebLinkAboutSeptic New 56 Beelzebub Road y. 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 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 6J1111AW 0ACA1/15143- Address of Owner
2. Location of Property 5 ro ���c.z�!'�6+ld /� � Lot. No. S
3. Type of Structure ZrAw"eAcc No. of Bedrooms
! (Dwelling,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 Tan Sd ges.44 Material of Septic TankA/Lo-J
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 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Total
Other
Signature ,6 S nA&T-
(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 S usr 19 46 3 By
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