HomeMy WebLinkAboutSeptic New 423 Chapel Road i
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. ZO 1910 S—
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following informati submitted:
1. Owner of Proper Address of Owner
2. Location of Proper So ®r Lot. No.
3. Type of Structure we'll zn!9 No. of Bedrooms
( elling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets �2N Urinals Lavatories Bathtubs_
Showers Kitchen Sinks_____ Laundry Tubs _ Garbage Grinder �i Other
� J
6. Liquid Capacity of Septic Tank Q (.�Material of Septic Tank OlJ C i 2 f'G
7. Soil Conditions: Type of Soil S G-17 GY— Maximum ground water table ®/7 L
(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 for embankment
10. Percolation Tests: Time for 1" drop in soil test g4l_ l Z00-TC,S Classification of soil
11. Minimum square feet of effective seepage area required 6—,0d ,$12,
12. Leaching System: Number of trenches Length Width Total
Other
Signature
icensed Install r)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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