HomeMy WebLinkAboutSeptic New 48 Blue Ridge Drive z13 TOWN OF SOUTH WINDSOR "
BUILDING DEPARTMENT
n ee Sou , Windsor, Connecticut
• Application for Permit to nsta I or Repair Individual Sewage Disposal System
��r Application No.
TO THE BUILDING DEPARTMENT: Date. //-/4/ 19,�al-
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property " r ira ` Address of Owner ee�
2. Location of Propert 1` S 2 S ILIA )�2 Lot. No. f S
3. Type of Structure \ , C-J) No. of Bedrooms_
(D euIng,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets ,;2- — Urinals Lavatories_ Bathtubs
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank .S> Material of Septic Tank d &j:Z I/ -e
7. Soil Conditions: Type of Soil f aOGe- e-,! S Q na Maximum ground water table
(SAnd,Gravel,Clay,etc.)
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 't/O Width_Q7 �-L Total bon d
Other
Signatur
(Licensed Install
(Sketch showing all minimum distances and other details reqst red below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 10 By