HomeMy WebLinkAboutSeptic New 140 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
Applica n No._ ��_
TO THE BUILDING DEPARTMENT: Date 19
A permit is requested for repair or construction of an individual sewage disp al system concerning which the
following information is submitted NA IW- ��odoS?
1. Owner of Propertv4 Address of Owne
2. Location of Property0R d Lot. No. �A
3. Type of Structure No. of Bedrooms_
(I)we g,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
n`s
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks — Laundry Tubs Garbage GrindeOther
6. Liquid Capacity of Septic Tank Z lS Material of Septic Tank R CCA� —
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,gay,etc.)
8. If not served by public water supply: Distance from Owner's wel 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 �d Total:n-7-V 40/0
Other
Signature
ensed Installe 4ic.
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(Sketch showing all minimum distances and other details require below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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fOR BUILDING PURPOSES.
NO. BIRCH HILL DRIVE SOUTH WINDSOR, CONN. ,
got No. 20- on map entitled "BIRCH HILT. ESTATES Poster Street
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8 'th Wi.nd.sor, Conn.. Property of U & R Housing Corp. Scale 1 " 1001 �
t� Jaw. 21 , 116,3 Hayd'en L. Orisxol.d C,E. " ;. ,