HomeMy WebLinkAboutSeptic New 230 Beelzebub Road TOWN OF SOUTH WINDSOR ,ee
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
QApplicati n No. �t7
TO THE BUILDING DEPARTMENT: Date
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is subm�ittteod,: ��3 6
Y-�� /� s �PA2�
1. Owner of Propert Address of Owner
2. Location of Property Lot. No.
c
3. Type of Structure No. of Bedrooms_
(DwellApk,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ A4� ,44 l&
5. Plumbing Fixtures: Water Closets Urinals Lavatories_ Bathtubs_
Showers - Kitchen Sinks _ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank H &I t&a&_Material of Septic Tank �� � lfJ✓/C
7. Soil Conditions: Type of Soil /fie i��/r ccue�f Maximum ground water table /yip
(Sand,Gravfflr,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well 27 0 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 ea _ Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Je Total
Other
Signature
(Licensed nstaller
(Sketch showing .II minimum distances and other details required below)
Q
1 �
C � �
/05
416
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By