HomeMy WebLinkAboutSeptic New 42 Birch HIll 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. 196_
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: RocNE /� _
1. Owner of Property Address of Owner R��*e� g
2. Location of Propert c Lot. No.
3. Type of Structure �/ No. of Bedrooms
( welling,yonimercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets ?�— Urinals Lavatories Bathtubs_
Showers Kitchen Mnks,_,f�'Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank C 0r�C �, �t yo:m
7. Soil Conditions: Type of Soil Pov -"F% aq Maximum ground water table -e-
( and,Gravel,Clay,etqV
8. If not served by public water supply: Distance from Owner's well j2 N ill 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 _, n Classification of soil
11. Minimum square feet of effective seepage area required
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12. Leaching System: Number,of trenches Length,-� "-�—p�— Width ® Total
Other �J Z/4
Signature
(Licensed Installer
(Sketch showing all minimum distances and other details required ow)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19___ By
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Date : Jan. r 1 , 1963 Haydefi L . gar• i < wo i d
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