HomeMy WebLinkAboutSeptic New 252 Buckland Road 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. / �,/ l 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 �f?T' .� - �1��, f Address of Owner 7�r7 07 Y
-
2. Location of Property Lot. No. 403>
3. Type of Structure No. of Bedrooms 0
/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. Material of Septic Tank
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 Width Total
Other
Signature
(LiAeniedi-ni.-
OILtaller)
(Sketch showing all minimum distances and other details required below)
t� �4
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By