HomeMy WebLinkAboutSeptic New 163 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 'on No.
TO THE BUILDING DEPARTMENT: Date 19
A permit is requested for repair or construction of an individual sewage dispoU system concerning which the
following information is submitted:
GRANT
1. Owner of Property Address of Owner "'�- �s
+6 2. Location of Property 04A�k Lot. No. I-T
3. Type of Structure No. of Bedroom
(DwellTg,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises-
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder
6. Liquid Capacity of Septic Tank. Material of Septic Tank a2_6_� a_v��
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,CZroOwner's
,etc.)
8. If not served by public water supply: Distance we] —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 SSG Width Y Total
Other
Signature
(Licensed staller)
(Sketch showing all minimum distances and other details squired below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 __ By
Fes'�� "--s�"1,� ;� "�'a,<`j��,,� %� � xic''•�, 3n+ �''� � t��'_-3.ar ,� 4'r j3 ' a�5-, � d', f�� aF!"b�..-� �y;= +t G
I
- � i ,. ,� .✓�a:-• r /`` tad I/'_J/lJ
1
� j 1
O
io
b
do
60
Ow
536
o :;i7' suRv�-``
h .w../ _ 2