HomeMy WebLinkAboutSeptic New 20 Breezy Hill Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
_` Applicat'on No.
TO THE BUILDING DEPARTMENT: Date 19_�
A permit is requested for repair or construction of an individual sewa disposal system concerning which the
following information is submitted:
1. Owner of Property Address of Owner._
2. Location of Property ot. No. /
3. Type of Structure No. of Bedrooms
wel i ,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 Other
6. Liquid Capacity of Septic Tank ,L�6 Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,G el, lay,V.)
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 3a^ Classification of soil
11. Minimum square feet of effective seepage area required f�
12. Leaching System: Number of trenches Length Width ,2,._,-jJ� Total
Other
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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