HomeMy WebLinkAboutSeptic Repair 329 Benedict Drive TOWN OF SOUTH WINDSOR f�
BUILDING DEPARTMENT x
South Windsor, Connecticut / ` ~v9,
Application for Permit to Install or� Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date CP// 19 61_-;>
A permit is requested fordgekair. construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property cd /d r At_ /HAt�Address of Owner c ,2 �iz�ri�c r c•r Clr,� �j';.J
2. Location of Propert "57 Lot. No.
3. Type of Structure 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 Tank Material of Septic Tank
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 &7Cs—
Other '
Signature
(Licensed Installer)
(Sketch showing all minimirn distances and other details required below)
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£i✓z D C �.e i d
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By