HomeMy WebLinkAboutSeptic New 664 Chapel Road TOWN OF SOUTH WI N DSOR r
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Ce q Application No.
TO THE BUILDING DEPARTMENT: Date 12` 2 ry 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 Address of Owner
2. Location of Property Lot. No.
3. Type of Structure No. of Bedrooms
Dwelling,C ercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
107
5. Plumbing Fixtures: Water Closets -21-- Urinals Lava pries Y Bathtubs _
Showers / Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank_ C7$ Material of Septic Tank A
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 r
(IAcens—ed Installer)
(Sketch showing all minimum distances and other details required )
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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