HomeMy WebLinkAboutSeptic New 70 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 1�r 19
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 Vf 74 Address of Owner 2 iyG �S Y
2. Location of Property c Lot. No.
3. Type of Structure W N-e �� No. of Bedrooms
(Dwe ng,Commercial Building,Store,
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets -- Urinals Lavatories _ Bathtubs_
Showers Kitchen Sinks Laundry Nubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank J c✓ Material of Septic Tank_�c�yc r l=& 6 d L4/
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 required
12. Leaching System: Number of trenches Length U Width Total
Other
Signature
(Licensed InstZbelow)
(Sketch showing all minimum distances and other details req
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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138. .34' I =?r.�2'
5 C.O-f`T DRIVE
PERMIT DLAN
LOT #126, "BIRCH HILL ESTATES" SECTION #6
TOWN OF SOUTH WINDSOR, CONNECTICUT
SCALE: 1" - 40'
� — L.S . # 4395
MAY 10, 19CD? Rockville, Conn.