HomeMy WebLinkAboutSeptic New 215 Benedict 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
A permit is requested for repair or construction of an individual sewag Isposal system concerning which the
following information is submitted:
1. Owner of Property tpQ ' Address of Owner -� �����L� " �y, �' •
2. Location of Property Lot. No. 2 O¢
3. Type of Structures No. of Bedrooms -'
ing,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ �-
5. Plumbing Fixtures: Water Closets Urinals Lavatories / Bathtubs
Showers f. Kitchen Sinks f Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank S` Material of Septic Tank � `
7. Soil Conditions: Type of Soil —f— 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 trenche ength � Width Total add
Other
Signature
(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 19 6 By