HomeMy WebLinkAboutSeptic New 56 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
Application No.
TO THE BUILDING DEPARTMENT: Date_
A permit is requested for repair or construction of an individual sewage disposal system concerning which the i^
following information is submitted: 1
1. Owner of Property Address of Own21A-e
2. Location of Property r R /efd Lot. No. n
3. Type of Structure No. of Bedrooms
(Dwelling 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 G Material of Septic Tank NC / t r �`t �'
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 f
f•
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 }
CP7 f� Q
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Ca V Width Total
G c)
Other
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details requir below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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42
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40 24
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LOT #125, "BIRCH HILL ESTATES"
SECTION #6
TOWN OF SOUTH WINDSOR, CONNECTICUT
SCALE: 1" = 40'
L.S . # 4 395
April 7, 1967 Rockville, Conn.
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