HomeMy WebLinkAboutSeptic Repair 337 Benedict Drive f
TOWN OF SOUTH WI N DSOR 142-ey
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install o e air Individual Sewage Disposal System
Application No.
Xlt�-
TO THE BUILDING DEPARTMENT: Date 9 ,�, 19,r S
A permit is requested fo repair r construction of an individual sewage disposal system concerning which the
following information is submitted:
J4h r?S ae/7 e.
L Owner of Property aL� 6�2� Address of Owner d33s./.�
2. Location of Property .C)9/1,F Lot. No. 17
3. Type of Structure w e l!e "� No. of Bedrooms --?
(13 ling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets / Urinals Lavatories_ Bathtubs
Showers Kitchen Sinks�L Laundry Tubs_/ Garbage Grinder Other
6. Liquid Capacity of Septic Tank A4 if. 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 r— Width 3/= r' Total 30-0
Other
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By