HomeMy WebLinkAboutSeptic New 30 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 ed `
i '36 Application No.
TO THE BUILDING DEPARTMENT: Date
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 Address of O ��er a Ol
2. Location of Property f r` 4 91 Lot. No. 12
3. Type of Structure § ry No. of Bedrooms
(Dwelling,Comm cial 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 Material of Septic Tank C k e Y, .r 4 • y
7. Soil Conditions: Type of Soil 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 requiredIN
12. Leaching System: Number of trenches Length �`" Width Total
�+ `
Other
Y
Signature
(Licensed Installer
(Sketch showing all minimum distances and other details requi d below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
1ICo 117
17Z.89'
r
4 2't �J 4
��50 Xee�J
5'
04
1'OVf RHANG — — b�
ss'r
134. 24'
1'V.RMIT PLAN
LOT #123, "'BIRCH HILL ESTATES"
SECTION #6
TOWN OF SOUTH WINDSOR, CONNECTICUT
SCALE: 1" e 40,
-'
L.S. # 4395
Rockville, Conn.
Post-it®Fax Note 7671 Date paog es�
To /. .< From
Co./Dept. Co.
Phone# Phone#
Fax# C Fax#
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