HomeMy WebLinkAboutSeptic New 28 Birch Road e000' TOWN OF SOUTH WI N DSOR 7f `
4 BUILDING DEPARTMENTd, �
South Windsor, Connecticut
Application for Permit to or Repair Individual Sewage Disposal System d;e
Application No. 7
TO THE BUILDING DEPARTMENT: Date ? 19 K5
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:Ru 0w l t4 Lk j a",
1. Owner of Property Address of Owner_ /�`= 1
2. Location of Property 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_ 0 Lavatories_ Bathtubs_
Showers_ Z Kitchen Sinks i Laundry Tubs_/ Garbage Grinder Other d __
6. Liquid Capacity of Septic Tank J 22 Material of Septic Tank -M
i
7. Soil Conditions: Type of Soil Maximum ground water table_ e
( nd,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well .S-0 from adjacent wells Z75
9. Distance to nearest water course, drainage ditch, storm drain or embankment t-&)6
10. Percolation Tests: Time for 1" drop in soil test 10/1" fo Classification of soil /9'
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Total
Other rr 1
Signature 1P
'(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Alf
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By