HomeMy WebLinkAboutSeptic New 230 Burnham Street (2) � e
� P
TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
��3 d Applicat' n N
TO THE BUILDING DEPARTMENT: Date
1s
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 Ownejj:�,Z,�.e
2. Location of Property
f L 4 f: Lot. No.
3. Type of Structure �^
welling,Commercial Building,Store,etc.) No. of Bedrooms
4. Number of Families or Persons to Occupy Premises_ z-
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank s�c}t�O � 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 IL pP y' 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 1� r�� Classification of soil
11. Minimum square feet of effective seepage area required s
12. Leaching System: Number of trenches Length �4(,�, Width i Total
Other
Signature_'R
(License�Ihsti )
(Sketch showing all minimum distances and other details required below)
t
Permit Issued 19 By
Installation Completed, Inspected and Approved_ 19 By