HomeMy WebLinkAboutSeptic New 435 Chapel 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. 712
TO THE BUILDING DEPARTMENT: Date. ZZ/,J 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 W1211% Address of Owner
2. Location of Property �� V Lot. No�
3. Type of Structure .919? • No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets l 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 Maximum ground water table fv�
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well v from adjacent wells
0. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test gz_Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Total! 10
Other
Signature I ,' 1 rz t
"Oticensed Installer)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 18 By
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�knstallation.Completed, Inspected and Approved 9
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