HomeMy WebLinkAboutSeptic New 250 Benedict Drive TOWN 70F SOUTH WI N DSOR
B U I L D I NG D EP A R T M E N T
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal SV m
Application No. ` V
TO THE BUILDING DEPARTMENT: Date
A permit is requested for repair or construction of an individual sewage disposal stem concerning which the
following information is submitted:
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1. Owner of Property L) C. - 6= Address of Owner Q N Q n c- I 'I
2. Location of Property� Lot. No. 4 3
3. Type of Structure (Dwelling, No. of Bedrooms 3
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4. Number of Families or Persons to Occupy Premises_ C) V%J G
5. Plumbing Fixtures: Water Closets )_ Urinals Lavatories Bathtubs_
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank LDID f=X Material of Septic Tank C Q hit 2 ry
7. Soil Conditions: Type of Soil n F Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well (?,I 'L from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embanNment
10. Percolation Tests: Time for 1" drop in soil test )A&N, n-f— Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Total
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 By