HomeMy WebLinkAboutSeptic New 121 Birch Hill Drive TOWN OF SOUTH WI N DSOR
BUIL-DING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Applic n No. ,TD
TO THE BUILDING DEPARTMENT: Date 19(o
A permit is requested for repair or construction of an individual sewa sposal system concerning which the
following information is submitted: MAwANSKI
1. Owner of Property Address of Owner ..._/
2. Location of Property- i 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 1/ Kitchen Sinks Laundry Tubs t/ Garbage Grinder Other
6. Liquid Capacity of Septic Tank g 00 Material of Septic Tank �C n zm,.&
7. Soil Conditions: Type of Soil -",cl Maximum ground water table
(SaVU,Gravel,Clay, c.)
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 o21046 Width Total
Other
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Signature
tensed Installer)
(Sketch showing all minimum distances and other details required below)
1
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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17,
FOR BUIDIN
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PR( PE'RTY OF
CIO . BIRCH HILL DRIVE, SOUTH WINDSOR , CONY.
Beirin Lot No . 11 on map entitled "BIRCH HILL 1 STAT1 ,S foster Street
South t-li rid sor , Conn . Property of U re 1{ Hous ing Corp . Scale I " = loot
Uat;e : Ja.n . 21 , 1 (163 flavder► ' ::ri.swold
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