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HomeMy WebLinkAboutSeptic New 206 Buckland Road 6�. TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT South Windsor, Connecticut Application for Permit to Install or Repair Individual Sewage Disposal System Applicatio o V6.011, TO THE BUILDING DEPARTMENT: Date � 19 A permit is requested for repair or construction of an individual sewage lspo 1 system concerning which the following information is submitted: 1. Owner of Property Address of Owner �o 2. Location of Property Lot. No. 3. Type of Structure No. of Bedrooms ZZ (-welling,Commercial Building,Store,etc.) 4. Number of Families or Persons t co��cupy Premises_ L 5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs Showers Kitchen Sinks G Laundry Tubs Garbage Grinder O,t er 6. Liquid Capacity of Septic Tank- ©a Material of Septic Tank 7. Soil Conditions: Type of Soil •- +n fi Maximum ground water table (Sand,Grav ,A,Clay,etc.) 8. If not served by public water supply: Distance from Owner's well 7 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 ..2 �' Classification of soil 11. Minimum square feet of effective seepage area required 12. Leaching System: Number of trenches 44 Length WidthTotal �O� Other Z� Signature (Licensed Installer) (Sketch showing all minimum distances and other details required below) 9/6 u �0l &i 2 T- Permit Issued 19 By Installation Completed, Inspected and Approved 19 By fle fs� � N r J Q' v z ,r 14 � I